Grade M, Flebbe H, Ghadimi B M
Klinik für Allgemein‑, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
Chirurg. 2019 May;90(5):387-397. doi: 10.1007/s00104-019-0802-y.
Over the past four decades, the treatment algorithms for rectal cancer have fundamentally changed, which resulted in a considerable improvement of oncological outcomes. In this context, the surgical concept of total mesorectal excision and the implementation of multimodal treatment strategies represent key milestones. These improvements were complemented by a standardized histopathological work-up of the surgical specimen and the introduction of high-resolution magnetic resonance imaging (MRI) diagnostics. In addition, novel surgical techniques have been introduced, such as laparoscopic and robotic rectal resection. Other technological innovations include intraoperative pelvic neuromonitoring and fluorescence imaging. This review highlights the current evidence for selected, sometimes controversially discussed principles of surgical treatment strategies in rectal cancer.
在过去的四十年里，直肠癌的治疗方案发生了根本性的变化，这使得肿瘤治疗效果有了显著改善。在此背景下，全直肠系膜切除术的手术理念以及多模式治疗策略的实施成为关键里程碑。这些改进辅以手术标本标准化的组织病理学检查以及高分辨率磁共振成像（MRI）诊断技术的引入。此外，还引入了新型手术技术，如腹腔镜和机器人直肠切除术。其他技术创新包括术中盆腔神经监测和荧光成像。本综述重点介绍了目前关于直肠癌手术治疗策略中某些有时存在争议的选定原则的证据。
