腹腔镜右结肠切除术:基于关键解剖原理的正确技术。

IF 1.7 4区 医学 Q2 SURGERY Minimally Invasive Therapy & Allied Technologies Pub Date : 2024-08-01 Epub Date: 2024-04-08 DOI:10.1080/13645706.2024.2332880
Marco Maria Lirici, Giovanni Dapri, Cristiano G S Huescher, John Marks
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引用次数: 0

摘要

自1990年代初以来,腹腔镜右结肠切除术一直是仅次于腹腔镜左结肠切除术和乙状结肠切除术的最先进的腹腔镜手术。腹腔镜右结肠切除术的适应症包括良性或恶性疾病。尽管适应症很多,但腹腔镜右结肠切除术或扩大右结肠切除术主要是针对盲肠、升结肠、肝曲或近端横结肠的癌症。在全球范围内,结直肠癌是第三大确诊癌症:2020 年,估计有 1,880,725 人被确诊为结直肠癌,其中 1,148,515 人为结肠癌病例,40% 的病例位于右侧结肠。这些数字表明,对右侧结肠癌进行肿瘤学上合理的手术具有极其重要的意义。最近,人们主张将结肠系膜全切除术作为根治性手术的最佳选择,尤其是结节阳性的右半结肠癌患者。腹腔镜标准右结肠切除术和带或不带结肠系膜的扩大右结肠切除术应根据明确的原则进行,并以对关键解剖标志的深入了解为基础。这些知识有助于追踪解剖结构并沿着正确的手术平面驱动器械,其基础来自于过去和现在的外科医生和科学家的教导。
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Laparoscopic right colectomy: correct technique based on key anatomical principles.

Since the early1990s, laparoscopic right colon resections have been the most performed advanced laparoscopic procedures just after laparoscopic left colectomies and sigmoid resections. Indications for laparoscopic right colectomies are either benign or malignant diseases. Despite its many indications, a laparoscopic right or extended right colectomy is mostly performed for cancer of the caecum, the ascending colon, the hepatic flexure or the proximal transverse colon. Worldwide, colorectal cancer is the third most diagnosed cancer: an estimated 1,880,725 people were diagnosed with colorectal cancer in 2020, out of which 1,148,515 were colon cancer cases and 40% were located in the right colon. These figures make an oncologic sound surgery for right colon cancer of the utmost relevance. More recently, complete mesocolic excision has been advocated as the optimal choice in term of radicality, especially in node-positive patients with right colon cancer. Laparoscopic standard right colectomy and extended right colectomy with or without CME should be performed according to defined principles based on a close knowledge of key anatomical landmarks. This knowledge will allow to trace anatomical structures and drive instruments along the correct surgical planes and has its foundations in teachings from surgeons and scientists of past and present time.

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来源期刊
CiteScore
3.80
自引率
5.90%
发文量
39
审稿时长
6-12 weeks
期刊介绍: Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.
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