Bleday R, Babineau T, Forse R A
Department of Surgery, New England Deaconess Hospital, Boston, Massachusetts 02215.
Semin Surg Oncol. 1993 Jan-Feb;9(1):59-64. doi: 10.1002/ssu.2980090112.
Laparoscopic techniques are now being applied to increasing numbers of general surgical procedures. Technical feasibility, margins, number of lymph nodes, and recurrence rates need to be assessed with the application of this new technique to colon or rectal malignancies. Technically, the right colon, sigmoid, and proximal rectum appear to be the most amenable to laparoscopic assisted or complete laparoscopic resection. Early results from a registry of laparoscopic assisted colectomies shows that there is no significant difference in the number of lymph nodes in the lymphovascular bundle compared to conventional colon resections. Early retrospective reports indicate that there may be a significant decrease in post op length of stay. We conclude that the technique of laparoscopic assisted colectomy for colon or rectal cancer needs to follow the same oncologic principles as that of conventional surgery, and ultimately a trial will be needed to compare conventional and laparoscopic cancer resections of the large bowel.
腹腔镜技术目前正应用于越来越多的普通外科手术中。在将这项新技术应用于结肠或直肠恶性肿瘤时，需要评估其技术可行性、切缘、淋巴结数量及复发率。从技术角度看，右半结肠、乙状结肠和直肠上段似乎最适合腹腔镜辅助或完全腹腔镜切除。腹腔镜辅助结肠切除术登记处的早期结果表明，与传统结肠切除术相比，淋巴管束中的淋巴结数量没有显著差异。早期回顾性报告表明，术后住院时间可能会显著缩短。我们得出结论，用于结肠癌或直肠癌的腹腔镜辅助结肠切除术技术需要遵循与传统手术相同的肿瘤学原则，最终需要进行一项试验来比较传统和腹腔镜大肠癌症切除术。
