腹腔镜下直肠癌根治术的争议与难点

Controversies and difficulties in laparoscopic radical resection for rectal cancer

随着腹腔镜直肠癌根治手术的改进,其应用也越来越广泛,其手术的安全性、可行性及远期疗效也逐渐得到认可,最新指南逐渐推荐腹腔镜技术代替开腹技术。然而在实施过程中,由于学习曲线长、技术难度大,仍存在诸多操作性问题,加之越来越清晰的"膜解剖理念"的出现,有必要对腹腔镜直肠癌根治术的争议与难点进行探讨,以供临床参考。

With the improvement of laparoscopic radical resection of rectal cancer and its wide- spread application, the safety, feasibility and long-term efficacy have been gradually recognized. Lapa- roscopic radical resection, rather than open procedure has been recommended by the recent guidelines. However, there are still many problems to be solved due to the prolonged learning curve, the difficul- ties in operation, and the clearer concept of ＂membrane anatomy＂. To provide reference for clinical practice, the controversies and difficulties in laparoscopic radical resection for rectal cancer need fur- ther discussion.