结直肠肿瘤经自然腔道取标本手术的器官功能保护优势  

Advantages of organ protection in colorectal tumor specimen collection through natural orifice specimen extraction surgery

作　　者：关旭 王锡山 Guan Xu;Wang Xishan(Department of Colorectal Surgery,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Bejing 100021,China)

机构地区：[1]国家癌症中心国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院结直肠外科,北京100021

出　　处：《中华胃肠外科杂志》2022年第6期500-504,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金项目(82100598);深圳市‘医疗卫生三名工程’(SZSM201911012)。

摘　　要：近年来,经自然腔道取标本手术(NOSES)在结直肠肿瘤外科中的应用愈加广泛。NOSES的快速发展主要归功于其本身的巨大优势和价值,包括减轻手术创伤、加速患者术后康复和减轻患者不良心理暗示等。NOSES这些优势也正是外科手术器官功能保护的重要体现和完美诠释。器官功能保护是当下外科的热议话题,也是微创外科手术开展的必然要求。从本质上讲,NOSES与器官功能保护的诞生初衷相同,发展目标高度契合。NOSES是外科手术器官功能保护的重要实践者,器官功能保护又是NOSES理论体系发展的风向标,两者相辅相成,共同构成了现代微创外科发展的重要元素。为全面论述NOSES与功能保护的关系,笔者从结直肠手术的5个主要操作环节入手,即手术入路、手术切除范围、淋巴结清扫程度、消化道重建方式和标本取出方式,详尽剖析NOSES手术中功能保护的重要作用与价值。In recent years,natural orifice specimen extraction surgery(NOSES)has been widely used in surgery of colorectal cancer.The rapid development of NOSES is mainly attributed to its own great advantages and values,including the reduction of surgical trauma,the acceleration of postoperative recovery and the reduction of adverse psychological reactions for patients.These advantages of NOSES are also important embodiment and perfect interpretation of the organ functional protection.Organ functional preservation is a hot topic in surgery today,and it is also an inevitable requirement for minimally invasive surgery.Essentially,NOSES and organ functional preservation are proposed in the same background,and the goals are highly compatible.NOSES is an important practitioner of organ functional preservation,and organ functional preservation is also the vane of the development of the theoretical system of NOSES.These two items complement each other and together constitute the important element in the development of modern minimally invasive surgery.In order to comprehensively discuss the relationship between NOSES and organ functional protection,we elaborate the important role and value of functional protection in NOSES from five key procedures of colorectal surgery,namely surgical approach,extent of resection,lymph node dissection,digestive tract reconstruction and specimen extraction.

关 键 词：经自然腔道取标本手术 器官功能保护 结直肠肿瘤 微创外科 

分 类 号：R735.34[医药卫生—肿瘤]