完整结肠系膜切除术的发展和评价

长期以来,结肠癌手术预后明显好于直肠癌.然而这一局面近20年来出现了逆转,究其原因直肠癌全直肠系膜切除术对于降低直肠癌局部复发,改善患者生存率的意义重大,而长期以来结肠癌缺少类似的质量控制性标准手术.尽管全球的外科医师知道结肠癌根治手术原则,然而通过何种方法能够保证达到良好的根治效果,目前尚存在争议.完整结肠系膜切除术的提出填补了这一空白,某种程度上讲它不是一种新的手术技术,然而它却对于如何实施高质量根治手术指明了方向.它基于解剖学和胚胎学理论,合理的提出了手术操作的层面,进一步诠释了结肠脏层筋膜的解剖结构,有利于外科医师学习和开展.

Development and Evaluation of Complete Mesocolic Excision in treating colon cancers

For long-time,the postoperative prognosis of colon cancers were significantly better than that in patients with rectal cancers,however,the situation changed in recent 20 years.One of the most important reasons is that total mesorectal excision(TME) for rectal cancers had reduced local recurrence and improved the survival significantly.Nevertheless colonal surgery lacked similar quality-control standardized operation.Despite global surgeons followed the principle of radical operation in treating colon cancers,it remained controversial that by using which method better curative effect could be achieved.The proposal of complete mesocolic excision(CME) might fill this blank.To some extent,it might be not a new operative technique,but it helped to achieve high quality of radical operation.It based on anatomy and embryology,advocated a reasonable operation level,further interpretated the anatomical structure of colonal visceral fascia,which was helpful for surgeons to learn and to carry out.