再论结肠癌手术规范化问题

结肠癌手术的规范化一直是临床医生关注的热点问题。近年来，伴随全结肠系膜切除（CME）概念的建立，规范定义了结肠癌手术的解剖层次入路，同时，也为获得高质量控制标准的组织病理标本评估提供了可能。2010年卫生部公布的《结直肠癌诊疗规范》已经成为结直肠癌规范化诊治的法律基础。但是．由于缺少手术细则而使“什么是结肠癌规范化手术”重新引起热议。笔者复习解读日本《大肠癌诊疗规范》（第7版）核心内容，检索2009年4月以来在期刊公开发表的关于CME研究的中英文文献，针对结肠癌凡切除手术所必须达到的肠管安全切除范围的理论基础和区域淋巴结清扫的合理性等问题提出商榷与思考．以飨同道。

Second thoughts on standardized surgery of colon cancer

Standardization of colon cancer surgery has been one of the hottest issues for to clinicians. The establishment of complete mesoeolie excision （CME） concept standardizes and defines the anatomic access of surgical procedures of colon cancer, and also provides the possibility to obtain high quality standards of pathological specimen assessment. In 2010 the Ministry of Health announced Standard of Diagnosis and Treatment of Coloreetal Cancer on the legal basis. However, hot discussion was present again, due to the lack of definition of standardized operation. Through reviewing Japanese Standard of Diagnosis and Treatment of Colon Cancer （7th Edition）, and the literature on CME published in English and Chinese since April 2009, the authors raise the discussion and reflection on theoretical basis that the safe bowel resection margin must be reached in colon cancer R0 surgery and rationality of regional lymph nodedissection.