结直肠癌外科手术的切缘

Resection margin of colorectal cancer surgery

判断结直肠癌外科手术的切缘,是影响肿瘤局部复发及远处转移的重要因素,对患者预后至关重要。如何选择规范的、理想的手术切缘,对结直肠肿瘤外科医生提出了挑战。结直肠癌手术切缘包括纵向切缘及环周切缘,不同指南中安全切缘的距离有所不同。手术切缘的判断,术前主要依靠影像学检查;术中结合术者的经验、手术方式、超光普显像和荧光血管造影等进行;术后需要病理检查确定。重视结直肠癌手术中的安全切缘,以减少肿瘤局部复发及远处转移,是结直肠肿瘤外科医生不变的追求。

The judgment of surgical resection margins is an important factor affecting local recurrence and distant metastasis of colorectal cancer,which is crucial to the prognosis of patients.How to select a standard and ideal surgical resection margin is a challenge for colorectal cancer surgeons.Surgical resection margins for colorectal cancer include longitudinal resection margin(LRM)and circumferential resection margin(CRM),and the distance of safe resection margins varies according to different guidelines.Surgical resection margins are mainly evaluated by preoperative imaging,operative experience,operative type,hyperspectral imaging(HPI)and fluorescence angiography(FA),and postoperative pathology.It is the constant pursuit of colorectal cancer surgeons to pay attention to the safe resection margins in colorectal cancer surgery to reduce local recurrence and distant metastasis.