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本文综述了腹腔镜辅助下结直肠肿瘤切除术这一外科领域的新技术在适应证方面和trocar穿刺部位及小切口部位肿瘤复发方面的争议。结直肠良性肿瘤和早期结直肠癌被认为是本术式的最佳适应证;对进展期的结直肠恶性肿瘤,到目前为止,尚缺乏一项较大样本的长期随机性前瞻性对照研究来比较此术式与传统的开腹手术;但普遍认为当肿瘤已侵出浆肌层时不适宜用此手术。对于trocar穿刺部位及小切口部位的肿瘤复发问题,大部分学者认为此项手术技术并没有增加肿瘤的复发率。
This article summarizes the controversy about the new technology in the surgical field of laparoscopic assisted colorectal neoplasm resection in indications and trocar puncture sites and tumor recurrence at small incision sites. Colorectal benign tumors and early colorectal cancers are considered to be the best indications for this procedure; for advanced colorectal malignancies, a large sample of long-term randomized prospective controlled studies is still lacking so far. This procedure was compared with traditional laparotomy; however, it is generally believed that this procedure is not suitable when the tumor has invaded the sarcomere. For trocar puncture site and small incision site tumor recurrence, most scholars believe that this surgical technique does not increase the recurrence rate of the tumor.