近十余年结直肠外科领域的理想与现实

The ideals and realities of colorectal surgery in the past ten years

规范的外科技术的发展离不开创新,创新能否成为规范需要验证,证据则来自临床研究。近十余年来,结直肠外科领域的创新一直伴随着临床研究的验证,如腹腔镜技术在结直肠癌手术中的临床应用探索和推广普及,对完整结肠系膜切除原则在右半结肠癌手术合理性的再认识过程,以及目前对经肛全直肠系膜切除手术和机器人手术的认识和评价,这些均展示了临床研究所提供的循证结果在验证外科创新时所发挥的作用。创伤微创化和手术规范化是外科技术发展的必然趋势,现有的外科创新均是围绕这一趋势而涌现。任何一种外科干预手段、外科创新技术的验证与推广都需要循序、循证,证据是鉴别创新与谬误的有效方法。

The development of standardized surgical techniques is inseparable from innovation.Whether innovation can become standardized needs to be verified,and the evidence comes from clinical research.In the past decade,innovation in the field of colorectal surgery has been accompanied by the verification of clinical research.For example,the clinical application and popularization of laparoscopic technology in colorectal cancer surgery,the re-recognition of the rationality of complete mesorectal excision principle in right hemicolon cancer surgery,and the current understanding and evaluation of transanal total mesorectal excision and robotic surgery,all of these show the role of evidence-based results provided by clinical research in verifying surgical innovation.Minimally invasive surgery and standardized surgery are the inevitable trend of surgical technology development,and the existing surgical innovations emerge around this trend.The verification and promotion of any surgical intervention and innovative surgical technology need to be sequential and evidence-based.Evidence is an effective method to identify innovation and fallacy.