Toiyama Yuji, Kusunoki Masato
Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine Institute of Life Sciences, Mie University Graduate School of Medicine Tsu Japan.
Ann Gastroenterol Surg. 2020 May 10;4(4):331-342. doi: 10.1002/ags3.12342. eCollection 2020 Jul.
Advances in surgical and adjuvant therapies have resulted in a dramatic improvement in outcomes of rectal cancer in terms of both oncology and functional preservation. Surgery plays a central role in therapy as it is the only means of achieving a complete cure. These surgical advancements result from extensive pioneering research in the fields of anatomy and physiology. Much history lies behind the recent surgical breakthroughs of total mesorectal excision (TME) and intersphincteric resection (ISR). This article outlines the changes that have taken place in surgical therapies for rectal cancer over more than a century based on clinical trials performed to provide scientific evidence for these therapies.
手术及辅助治疗的进展使直肠癌在肿瘤学和功能保留方面的治疗效果有了显著改善。手术在治疗中起着核心作用,因为它是实现完全治愈的唯一手段。这些手术进展源于解剖学和生理学领域广泛的开创性研究。全直肠系膜切除术(TME)和括约肌间切除术(ISR)等近期手术突破背后有着诸多历史。本文基于为这些治疗方法提供科学依据而进行的临床试验,概述了一个多世纪以来直肠癌手术治疗所发生的变化。