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结直肠癌外科治疗的技术进展

Technological Advances in the Surgical Treatment of Colorectal Cancer.

作者信息

Hahn Sue J, Sylla Patricia

机构信息

Division of Colon and Rectal Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai Hospital, 5 East 98th Street, Box 1259, New York, NY 10029, USA.

出版信息

Surg Oncol Clin N Am. 2022 Apr;31(2):183-218. doi: 10.1016/j.soc.2022.01.001.

Abstract

Efforts toward standardization of surgical techniques have facilitated adoption of oncologic resections for colorectal cancer with associated improvement in outcomes. With the introduction of laparoscopy, total mesorectal excision (TME) and complete mesocolic excision (CME) techniques were progressively adapted to the minimally invasive surgery (MIS) approach with significant benefits with regards to patient recovery and comparable oncologic outcomes when performed by surgeons beyond their learning curve. Anastomotic complications and functional disturbances following TME remain significant. Recent innovations include intracorporeal anastomosis, which avoids midline extraction sites, and transanal TME, which lowers conversion rates and facilitates sphincter preservation for low rectal tumors.

摘要

外科技术标准化的努力促进了结直肠癌肿瘤切除术的采用,并改善了治疗效果。随着腹腔镜技术的引入,全直肠系膜切除术(TME)和完整结肠系膜切除术(CME)技术逐渐应用于微创手术(MIS),对于患者恢复具有显著益处,并且当由经验丰富的外科医生操作时,其肿瘤学结局相当。TME术后的吻合口并发症和功能障碍仍然很严重。最近的创新包括避免经中线取出部位的体内吻合术,以及降低中转率并便于低位直肠癌保留括约肌的经肛门TME。

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