中国实用外科杂志2024，Vol.44Issue(1)：66-69,4.DOI:10.19538/j.cjps.issn1005-2208.2024.01.10
腹腔镜结直肠癌手术关键技术标准及评价
Standardization and assessment of the key techniques in laparoscopic surgery for colorectal cancer
摘要
Abstract
Several large-scale clinical studies have confirmed the safety and effectiveness of laparoscopic surgery for colorectal cancer,and laparoscopy has become the main modality of colorectal cancer surgical treatment in China.Nowadays,laparoscopic colorectal surgical techniques are still being continuously optimized and improved,and its key techniques are mainly reflected in the following three aspects:(1)complete surgical resection range,(2)appropriate lymph node dissection range,(3)safe digestive tract reconstruction.Rectal cancer surgery should adhere to the principles of total mesorectal excision(TME),ensuring the integrity of the mesorectum and negative circumferential margins.Selective resection of the root of the superior rectal artery and lateral lymph nodes should be based on the depth of tumor infiltration and metastasis.Colon cancer surgery should follow the concept of complete mesocolic excision(CME),involving the complete separation of the colonic visceral fascia from the parietal fascia,clearing up to the third-tier lymph nodes,thereby increasing lymph node retrieval rates and reducing local recurrence rates.The extent of colon resection in colon cancer should meet the requirements of clearing the area of metastatic lymph nodes,following either the Western'10 cm principle'or the Japanese'10+5'principle.Personalized decisions regarding lymph node dissection should consider factors such as tumor location,staging,metastasis,and preoperative imaging.Gastrointestinal tract reconstruction is a crucial component of laparoscopic colorectal cancer surgery.Standardized reconstruction plays a significant role in improving surgical success rates,reducing the incidence of surgical complications,and promoting postoperative patient recovery.Advancing standardized surgical practices,establishing scientific surgical technique assessment tools,and conducting high-quality clinical research are crucial for elevating the standardization level of laparoscopic colorectal cancer surgery in our country.关键词
腹腔镜手术/结直肠癌/手术操作/标准化/质量控制Key words
laparoscopic surgery/colorectal cancer/surgical procedure/standardization/quality control分类
医药卫生引用本文复制引用
姚宏伟,宋建宁,魏鹏宇,张忠涛..腹腔镜结直肠癌手术关键技术标准及评价[J].中国实用外科杂志,2024,44(1):66-69,4.基金项目
国家科技支撑计划项目(No.2015BAI13B09) （No.2015BAI13B09）
国家重点研发计划资助项目(No.2017YFC0110904) （No.2017YFC0110904）
北京市医院管理中心扬帆计划临床技术创新项目(No.ZLRK202302) （No.ZLRK202302）
首都医科大学结直肠肿瘤临床诊疗与研究中心基金项目(No.1192070313) （No.1192070313）
