摘要
低位直肠癌(LRC)患者的治疗模式仍以手术为主。随着医学技术的进步,目前的手术模式更倾向于“保全器官与功能”的超级微创手术(SMIS)。SMIS属于器官保留式手术,包括消化内镜下非全层和全层切除术、腹腔镜或机器人下全层切除术以及经肛门微创手术等,能够涵盖TNM分期的各个阶段。本文阐述了术前精准诊断和风险分层对于选择合适的SMIS方式的重要性,以及影像学技术在精准预测淋巴结转移、提供术前TNM分期和风险分层,并指导SMIS治疗的新进展。最后,介绍了目前已开展的和处于临床研究阶段的治疗LRC的SMIS术式选择方案,以期更大限度地提高LRC患者的生活质量。
The treatment mode for patients with low rectal cancer(LRC)is still mainly surgical treatment.With the advancement of medical technology,the current surgical mode is more inclined towards super minimally invasive surgery(SMIS)that preserves organs and functions.SMIS belongs to organ preservation surgery,including non-full thickness and full-thickness resection under digestive endoscopy,laparoscopic or robotic full-thickness resection,and transanal minimally invasive surgery,which can cover all stages of TNM staging.The paper elaborates on the importance of preoperative accurate diagnosis and risk stratification in selecting appropriate SMIS methods,the new progress of imaging technology in accurately predicting lymph node metastasis,providing preoperative TNM staging and risk stratification,and guiding SMIS treatment.Finally,the paper introduces the SMIS surgical options for the treatment of LRC that have been developed and are currently in the clinical research stage,with the aim of maximizing the quality of life for LRC patients.
作者
陈倩倩
令狐恩强
Chen Qianqian;Linghu Enqiang(Department of Digestive Endoscopy Super Minimally Invasive,Department of Gastroenterology,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2024年第35期3288-3291,共4页
National Medical Journal of China
基金
国家重点研发计划(2022YFC2503600)
关键词
直肠肿瘤
超级微创手术
全层切除术
腹腔镜手术
淋巴结转移
保肛手术
Rectal neoplasms
Super minimally invasive surgery
Full thickness resection
Laparoscopic surgeries
Lymph node metastasis
Anal-preserving operation
