结直肠肿瘤手术的质量控制

Quality control of colorectal tumor surgery

手术是结直肠癌获得根治的主要手段。以腹腔镜和机器人手术为代表的微创外科治疗已逐渐成为现阶段结直肠肿瘤手术的主流方式。与此同时,功能保留手术治疗理念的兴起,使人们从单纯强调肿瘤学根治转变为强调根治与器官功能保护两者并重的治疗目的。结直肠肿瘤手术实施的质量化控制包括手术资质准入制度、考核制度、手术方式和指征、手术关键技术(正确层面拓展、淋巴结清扫区域和切除范围、神经保护与功能保留以及消化道重建和术中并发症防治)等。统一规范的手术实施质量控制不仅是决定患者预后和生活质量的关键因素,也是确保相关临床研究结论准确性的重要前提。

Surgery is the main means of achieving cure for colorectal cancer.Minimally invasive surgery,represented by laparoscopy and robotic surgery,has gradually become the mainstream approach for colorectal cancer at present.At the same time,the concept of surgery has appeared from simply emphasizing oncological radical treatment to emphasizing both radical treatment and function preservation.The quality control of colorectal cancer surgery includes the qualification admission system and assessment system,surgical approaches and indications,key surgical techniques(correct plain extension,lymph node dissection and resection range,nerve protection and function preservation,digestive tract reconstruction,and intraoperative prevention and treatment of complications).Unified and standardized quality control of surgery is not only a key factor in determining patient prognosis and quality of life,but also an important prerequisite for ensuring the accuracy of clinical trial.