微创胃肠外科三十年历程与展望

Thirty years'evolution and prospects of minimally invasive gastrointestinal surgery in China

腹腔镜外科技术历经三十余年的发展已经成为外科手术的主要平台技术,在外科手术各个领域得到广泛应用。在结直肠外科,腹腔镜技术的安全性可行性和疗效已得到证实。近年来,随着对腹腔镜下膜解剖等理念与概念的进一步深刻认识,腹腔镜结直肠手术在手术入路选择、淋巴清扫范围、邓氏筋膜是否保留、功能保护、侧方淋巴清扫、超低位直肠癌保肛技术选择、全腔镜消化道重建等方面均有新的探讨和进展。腹腔镜胃外科领域,一方面国内循证医学证据进入收获期,另一方面,保功能手术、食管胃结合部腺癌、全腔镜吻合等也都成为这一领域的热点,并有新的进展。而微创手术相关的医疗装备也在近年获得发展,并对微创手术的提高起到推动作用。

After more than thirty years of development,laparoscopic surgery technology has become the main platform for surgery and has been widely applied in various fields of surgery.The safety,feasibility and efficacy of laparoscopic technique have already been confirmed in colorectal surgery.In recent years,with a deeper understanding of concepts such as laparoscopic fascial anatomy,laparoscopic colorectal surgery has made new explorations and advances in surgical approach selection,NOSES,lymph node dissection range,preservation of Denonvillier's fascia,functional protection,lateral lymph node dissection,selection of anal preservation techniques for ultra-low rectal cancer,and totally laparoscopic digestive tract reconstruction.In the field of laparoscopic gastric surgery,evidence-based medical evidence in China has entered a harvest period,moreover,functional preservation surgery,esophageal gastric junction adenocarcinoma,and total laparoscopic anastomosis have also become hot topics in this field with new progress.The medical equipment related to minimally invasive surgery has also been developping in recent years and has played an important role in improving minimally invasive surgery.