腹腔镜治疗结直肠癌。

Giovanna M da Silva, Lars Börjesson, Steven D Wexner
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引用次数: 13

摘要

腹腔镜在治疗良性疾病中的优势已经得到了很好的证明。与开放手术相比,腹腔镜手术住院时间更短,肠梗阻更少,术后疼痛减轻,更早恢复工作,美容效果更好。然而,腹腔镜在恶性疾病治疗中的作用仍然存在争议。为了阐明腹腔镜治疗恶性肿瘤的安全性和有效性,在世界范围内开展了大规模的随机对照试验。在等待大型随机试验结果的同时,对迄今为止发表的许多研究进行了回顾,证明了当由适当熟练的外科医生在适当选择的患者中进行腹腔镜手术时,在短期效益方面优于剖腹手术的高水平证据。数据还显示相似或更高的局部复发率和长期生存率。然而,在推荐该技术被广泛接受之前,还需要对大型、多中心、随机试验进行进一步的随访和评估。
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Laparoscopy for colorectal cancer.

The advantages of laparoscopy in the treatment of benign disease have been well demonstrated. Compared to open surgery, laparoscopy is associated with a shorter hospital stay, less ileus, decreased postoperative pain, earlier return to work, and better cosmesis. The role of laparoscopy for the cure of malignant disease, however, remains controversial. In order to elucidate the safety and efficacy of laparoscopy for malignancy, worldwide large controlled randomized trials were developed. While awaiting the results of large randomized trials, a review of the many published studies to date was undertaken demonstrating a high level of evidence of the superiority of laparoscopy over laparotomy in regard to short-term benefits, when performed by appropriately skilled surgeons in properly selected patients. The data also suggest similar or superior local recurrence and long-term survival rates. However, further follow-up and review of large, multicenter, randomized trials will be needed before widespread acceptance of the technique can be recommended.

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