Monson J R, Hill A D, Darzi A
University of Hull, Academic Surgical Unit, Castle Hill Hospital, Cottingham, North Humberside, UK.
Br J Surg. 1995 Feb;82(2):150-7. doi: 10.1002/bjs.1800820205.
Laparoscopic surgical techniques have recently entered the field of colorectal surgery. Because the laparoscopic approach has revolutionized biliary surgery, it is hoped that similar advances will be possible in the more elderly population with colorectal disease. Early experience suggests that such advances have not been achieved and there is concern about developing minimal access surgical techniques in the face of potentially curable cancer. This article reviews the current state of knowledge based on published series; however, the current lack of controlled data in patients with extended follow-up makes this area highly controversial. Suggestions regarding the future of laparoscopic surgery are made and include the establishment of a national register and the development of controlled randomized trials.
腹腔镜手术技术最近已进入结直肠外科领域。由于腹腔镜手术方法给胆道外科带来了变革,人们希望在患有结直肠疾病的老年人群中也能取得类似的进展。早期经验表明,此类进展尚未实现,而且在面对潜在可治愈的癌症时,对于开发微创外科技术存在担忧。本文基于已发表的系列研究综述了当前的知识状况;然而,目前缺乏对患者进行长期随访的对照数据,这使得该领域极具争议性。文中提出了关于腹腔镜手术未来发展的建议,包括建立全国性登记系统以及开展对照随机试验。