中国腹腔镜直肠癌手术30年术式变迁与发展

doi:10.3877/cma.j.issn.1674-3946.2021.01.003

中华普外科手术学杂志(电子版) ›› 2021, Vol. 15 ›› Issue (01) : 10 -13. doi: 10.3877/cma.j.issn.1674-3946.2021.01.003

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中国腹腔镜直肠癌手术30年术式变迁与发展

杜晓辉¹^,^†(

), 杨华夏¹

^1. 100853　北京，解放军总医院第一医学中心普通外科

收稿日期:2020-01-23 出版日期:2021-02-10
通信作者: 杜晓辉

Changes and development of laparoscopic rectal cancer surgery over the past 30 years in China

Xiaohui Du¹^,^†(), Huaxia Yang¹

^1. Department of General Surgery, First Medical Center, PLA General Hospital, Beijing 100853, China

Received:2020-01-23 Published:2021-02-10
Corresponding author: Xiaohui Du
Supported by:
National Natural Science Foundation of China(81871317); National Natural Science Foundation of China(61471397); National Natural Science Foundation of China(61170123)

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直肠癌是结直肠癌中占比最高的疾病，手术治疗是治愈直肠癌最重要的手段。中国腹腔镜辅助直肠癌手术自1993年首次报道，随着腹腔镜设备及技术的发展，极大的促进了腹腔镜辅助直肠癌手术的革新，腹腔镜辅助直肠癌手术已成为直肠癌患者治疗的标准术式。本文总结了腹腔镜直肠癌手术相关术式包括手辅助腹腔镜手术、经自然腔道直肠肿物取出术、经肛全直肠系膜切除术、经肛提肌外腹会阴联合切除术、单孔腹腔镜手术及相关循证研究进展。腹腔镜辅助直肠癌手术部分关键问题依然存在争议，但随着RCT研究的开展论证，这些问题都将得到解决。未来个体化的腹腔镜直肠癌手术必将明显改善直肠癌患者的预后。

关键词: 直肠肿瘤, 腹腔镜检查, 外科手术, 微创性

Rectal cancer is the disease with the highest proportion of colorectal cancer, and surgical treatment is the most important means to cure rectal cancer. Laparoscopic-assisted rectal cancer surgery was first reported in China in 1993. With the development of laparoscopic equipment and technology, it has greatly promoted the innovation of laparoscopic-assisted rectal cancer surgery. Laparoscopic-assisted rectal cancer surgery has become the standard treatment method for rectal cancer patients. This article summarized the related operative procedures of laparoscopic rectal cancer surgery, including hand-assisted laparoscopic surgery, natural orifice specimen extraction surgery, total trans-anal mesentery resection , extra-levator abdominoperineal excision, and laparoscopic single-site surgery as well as research progress of endoscopic surgery and related evidence-based research. Some key issues of laparoscopic-assisted rectal cancer surgery are still controversial, but with the development of the RCT research, these issues will be resolved. In the future, individualized laparoscopic rectal cancer surgery will significantly improve the prognosis of patients with rectal cancer.

Key words: Rectal neoplasms, Laparoscopy, Surgical procedures, minimally invasive

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