Ota D M, Nelson H, Weeks J C
University of Missouri-Ellis Fischel Cancer Center, Columbia, USA.
Curr Opin Gen Surg. 1994:208-13.
Surgical investigators have shown that a hemicolectomy can be done laparoscopically. This minimally invasive approach to treat colon cancer potentially reduces hospitalization time, hastens return to normal activity, and reduces health care costs. Hopefully, all of these favorable outcomes can be achieved without compromising cancer control. At present, however, the issues regarding laparoscopic colectomy are not clear, and prospective studies are necessary to validate that this new procedure is superior to open colectomy. Because cancer control might be compromised by this new procedure, laparoscopic colectomy should not be accepted by the surgical community because of the allure of new technology or the hope that it is equivalent to open colectomy in controlling a curable disease. Rather, a randomized trial of laparoscopic colectomy compared with open colectomy is needed to prove that cancer control is not different and that laparoscopic colectomy is cost-effective.
外科研究人员已经表明,半结肠切除术可以通过腹腔镜进行。这种治疗结肠癌的微创方法有可能缩短住院时间,加快恢复正常活动,并降低医疗成本。希望在不影响癌症控制的情况下实现所有这些良好结果。然而,目前关于腹腔镜结肠切除术的问题尚不清楚,需要进行前瞻性研究来证实这种新手术优于开放性结肠切除术。由于这种新手术可能会影响癌症控制,腹腔镜结肠切除术不应因其新技术的吸引力或其在控制可治愈疾病方面等同于开放性结肠切除术的希望而被外科界所接受。相反,需要进行一项将腹腔镜结肠切除术与开放性结肠切除术进行比较的随机试验,以证明癌症控制没有差异且腹腔镜结肠切除术具有成本效益。