Yamauchi Shinichi, Matsuyama Takatoshi, Tokunaga Masanori, Kinugasa Yusuke
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
JMA J. 2021 Jan 29;4(1):17-23. doi: 10.31662/jmaj.2020-0089. Epub 2021 Jan 14.
In recent years, minimally invasive surgery for colorectal cancer has seen remarkable improvement. For the laparoscopic surgery for colon cancer, earlier postoperative recovery and reduced hospital stays can be expected compared to those for open surgery. Also, no increase in perioperative morbidity and mortality has been shown. Furthermore, long-term oncological outcomes comparable to open surgery have been obtained. Although laparoscopic surgery for rectal cancer has shown good short-term postoperative outcomes, recent randomized controlled trials could not demonstrate non-inferiority to open surgery with respect to oncological safety. Further studies are required to confirm the impact of robotic surgery on colon and rectal cancer and the appropriate indications for transanal total mesorectal excision for rectal cancer.
近年来,结直肠癌的微创手术取得了显著进展。对于结肠癌的腹腔镜手术,与开放手术相比,术后恢复更早,住院时间缩短。此外,围手术期发病率和死亡率并未增加。而且,已获得与开放手术相当的长期肿瘤学结局。虽然直肠癌的腹腔镜手术已显示出良好的术后短期结局,但最近的随机对照试验未能在肿瘤学安全性方面证明其不劣于开放手术。需要进一步研究以证实机器人手术对结肠癌和直肠癌的影响以及直肠癌经肛门全直肠系膜切除术的合适适应证。