Department of Surgical Sciences, University of Torino, Turin, Italy.
Department of Surgery, Division of Colorectal Surgery, Baylor University Medical Center, 3409 Worth Street. Worth Tower, Suite 640, Dallas, TX, 75246, USA.
Ann Surg Oncol. 2020 Oct;27(10):3704-3715. doi: 10.1245/s10434-020-08833-8. Epub 2020 Jul 9.
Current high-quality evidence supports the routine use of the laparoscopic approach for patients with colon cancer. Laparoscopic colectomy is associated with earlier resumption of gastrointestinal function and shorter hospital stay, with no increased morbidity or mortality. Pathology and long-term oncologic outcomes are similar to those achieved with open surgery. The absolute benefits of laparoscopic resection for rectal cancer are still under evaluation. While its safety in terms of early postoperative clinical outcomes has been confirmed, two recent randomized controlled trial (RCTs) have questioned its routine use even in expert hands, since its non-inferiority has not been demonstrated when compared with the gold standard of open surgery. Furthermore, the impact of robotic technology is still unclear, since the only RCT available so far failed to demonstrate any benefits compared with standard laparoscopic rectal resection.
目前高质量证据支持将腹腔镜方法常规用于结肠癌患者。腹腔镜结肠切除术与更早地恢复胃肠功能和更短的住院时间相关，且发病率和死亡率没有增加。病理和长期肿瘤学结果与开放手术相似。腹腔镜直肠切除术的绝对获益仍在评估中。虽然其在术后早期临床结局方面的安全性已得到确认，但最近两项随机对照试验（RCT）甚至对其在专家手中的常规使用提出了质疑，因为与开放手术这一金标准相比，其并不具有非劣效性。此外，机器人技术的影响仍不清楚，因为目前唯一的 RCT 未能显示与标准腹腔镜直肠切除术相比有任何获益。
