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[超微创手术改变直肠癌治疗模式]

[Super minimally invasive surgery changing the treatment paradigm for rectal cancer].

作者信息

Chen Q Q, Linghu E Q

机构信息

Department of Digestive Endoscopy Super Minimally Invasive, Department of Gastroenterology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2024 Sep 10;104(35):3288-3291. doi: 10.3760/cma.j.cn112137-20240205-00278.

Abstract

The treatment mode for patients with low rectal cancer (LRC) is still mainly surgical treatment. With the advancement of medical technology, the current surgical mode is more inclined towards super minimally invasive surgery (SMIS) that preserves organs and functions. SMIS belongs to organ preservation surgery, including non-full thickness and full-thickness resection under digestive endoscopy, laparoscopic or robotic full-thickness resection, and transanal minimally invasive surgery, which can cover all stages of TNM staging. The paper elaborates on the importance of preoperative accurate diagnosis and risk stratification in selecting appropriate SMIS methods, the new progress of imaging technology in accurately predicting lymph node metastasis, providing preoperative TNM staging and risk stratification, and guiding SMIS treatment. Finally, the paper introduces the SMIS surgical options for the treatment of LRC that have been developed and are currently in the clinical research stage, with the aim of maximizing the quality of life for LRC patients.

摘要

低位直肠癌(LRC)患者的治疗模式仍以手术治疗为主。随着医学技术的进步,目前的手术模式更倾向于保留器官和功能的超微创手术(SMIS)。SMIS属于器官保留手术,包括消化内镜下非全层和全层切除、腹腔镜或机器人全层切除以及经肛门微创手术,可涵盖TNM分期的所有阶段。本文阐述了术前准确诊断和风险分层在选择合适的SMIS方法中的重要性,成像技术在准确预测淋巴结转移、提供术前TNM分期和风险分层以及指导SMIS治疗方面的新进展。最后,本文介绍了已开发且目前处于临床研究阶段的用于治疗LRC的SMIS手术选择,旨在最大限度地提高LRC患者的生活质量。

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