中国腹腔镜直肠癌手术30年术后主要并发症防治策略

Prevention and therapeutic strategies of major complications after laparoscopic rectal cancer surgery,Chinese experience in the past 30 years

随着腹腔镜器械的进步及手术技术的发展,腹腔镜直肠癌根治手术已经成为目前的主流术式。腹腔镜直肠癌手术能够提供更好的手术视野、更精细化的解剖认知、更小创伤的微创治疗理念,在国内外均获得了较好的临床疗效。此外随着大样本前瞻性随机对照试验(RCT)研究数据的发表,让我们也消除了腹腔镜直肠癌手术对于肿瘤学不良结局的顾虑。但是,腹腔镜直肠癌手术后的相关并发症仍临床治疗的难点和重点,也令外科医师们存在一定的敬畏。本文通过对近几年国内外文献的复习并结合我中心的治疗经验,以阐明腹腔镜直肠癌术后常见并发症类型、病因以及防治策略,为降低腹腔镜直肠癌术后并发症发生率提供更多的经验。

With the advancement of laparoscopic instruments and the development of surgical techniques,laparoscopic rectal cancer surgery has become the current mainstream operation.Laparoscopic rectal cancer surgery could provide better surgical vision,more refined anatomy,with less injury,and could achieve better clinical outcome both in China and abroad.Accumulated data from large-sample prospective randomized controlled trials(RCT)research eliminated the concept that laparoscopic rectal cancer surgery might result in a poor oncology outcome.However,complications related to laparoscopic rectal cancer surgery are still the challenge in clinical application for some surgeons.Based on domestic and foreign literatures in recent years and combined with the treatment experience of our center,this article clarifies the types of common complications,causes and prevention strategies after laparoscopic rectal cancer surgery,in order to provide reference to reduce the incidence of complications after laparoscopic rectal cancer surgery.