完全腹腔镜结肠癌根治术的技术难点与对策

Technical difficulties and countermeasures in total laparoscopic colon cancer surgery

随着腹腔镜技术的日渐成熟,完全腹腔镜结肠手术成为目前腹腔镜结肠手术细分领域的实践项目和研究热点之一。完全腹腔镜结肠手术可以减少肠管及系膜的游离范围、减轻对肠管的牵拉、缩小腹部切口,理论上具有加快病人术后康复的优势。但目前在相关领域尚存较多关键问题和争议,包括不同部位结肠癌的术式选择、顺蠕动和逆蠕动吻合、术后吻合口漏发生率等,有待更多高等级循证医学证据。完全腹腔镜手术具有较好的发展前景,但由于临床实践仍不成熟,目前还难以完全替代腹腔镜辅助手术,未来有待更多的手术实践和临床研究。

With the development of laparoscopic technique techniques,total laparoscopic colon surgery has become one of the current practice programs and research hotspots.Total laparoscopic colon surgery can reduce the dissection range of bowel and mesentery and reduce the abdominal incision,which theoretically has the advantage of accelerating postoperative recovery.At present,there are still many key issues and controversies in the related fields,including the choice of operative modality for different sites of colorectal cancer,isoperistaltic versus antiperistaltic,and the incidence of anastomotic leakage,and more high-grade evidence-based medical evidence is needed.Complete laparoscopic surgery has a good development prospect,it is still difficult to completely replace laparoscopic-assisted surgery,and more surgical practice and clinical research are required.