Köhler L, Fischer F, Troidl H
II. Chirurgischer Lehrstuhl, Universität zu Köln-Kliniken der Stadt Köln-Krankenhaus Merheim.
Zentralbl Chir. 1997;122(12):1120-4; discussion 1125-6.
The importance of so-called oncological standards is stressed every time an innovation is introduced in surgical practice. It has been stated that for colorectal cancer surgery the following oncological rules must be followed: wide tumor resection with gentle tumour removal, en bloc resection of the tumour without tumour cell spillage, no-touch isolation technique, primary ligation of the vessels and systematic lymph node dissection. Most of these oncological standards and rules are imprecise and unproven. Prognosis of the patients is not improved. Operative trauma has been shown to be associated with reproducible alterations in host immune function. This weakening of the immune system may increase risk of distant recurrence arising from exfoliated malignant cells during the operation. Up to now it is not known if laparoscopic technique diminishes these adverse effects on the immune response.
每当外科手术实践中引入一项创新时，所谓的肿瘤学标准的重要性就会被强调。有人指出，对于结直肠癌手术，必须遵循以下肿瘤学规则：广泛切除肿瘤并轻柔地移除肿瘤，整块切除肿瘤且无肿瘤细胞溢出，非接触隔离技术，血管的原位结扎以及系统性淋巴结清扫。这些肿瘤学标准和规则大多不精确且未经证实。患者的预后并未得到改善。手术创伤已被证明与宿主免疫功能的可重复性改变有关。免疫系统的这种削弱可能会增加手术过程中脱落的恶性细胞引发远处复发的风险。到目前为止，尚不清楚腹腔镜技术是否能减少这些对免疫反应的不利影响。
