胰腺外科微创手术临床研究进展及发展趋势

Progress and development trends of clinical researches in pancreatic minimally invasive surgery

近年来,随着微创器械、设备的发展和手术技术的进步,胰腺微创外科进入了快速发展阶段,推动了大量临床研究的开展。研究表明:相比于传统开放手术,微创胰腺手术在减少手术创伤、缩短住院时间、加速病人术后康复方面具有一定优势,但在手术适应证选择、肿瘤根治性及术后并发症等方面仍有争议,亟需开展高质量临床研究。然而,目前的临床研究多为回顾性,前瞻性随机对照研究数量仍较少,且样本数量有限,难以充分回答上述争议,给胰腺微创外科的快速发展带来了一定阻碍。因此,扩大前瞻性研究样本量,探究胰腺癌病人的生存获益,关注术者的学习曲线,客观评估微创手术对并发症的影响并采取相应的预防措施将是未来胰腺微创手术研究的方向。

With the development of minimally invasive surgical instruments, equipment and techniques, the pancreatic minimally invasive surgery has moved into a rapid development stage in recent years, and promoted the progress of adequate clinical researches. Studies have found that minimally invasive surgery has advantages in damage controlling, shortening the length of stay and enhancing recovery compared with open surgery. However, there are controversies about the indications, radical resection and complications, which needs high-quality clinical researches.Most of the present clinical researches are retrospective, and the number of randomized control trials is very few, which cannot solve all of the controversies and inhibit the development of pancreatic minimally invasive surgery.Therefore, the future clinical research direction of minimally invasive surgery is to expand the prospective study sample,explore the survival benefits of pancreatic cancer patients, pay attention to the learning curve of the operators, objectively evaluate the impact of minimally invasive surgery on complications and take corresponding preventive measures.