,Minimally invasive surgery of malignancies: time to argue the fundamental reasons for this emerging

来源 :肝胆外科与营养 | 被引量 : 0次 | 上传用户:hongxu815
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In recent years with the fast development of new surgical techniques and equipments, the indications for laparoscopic as well as robotic surgeries have continued making breakthroughs. In the case of hepatectomies, it could include total caudate lobectomy, hepatectomy for recurrences, and even combined macrovascular resection and remodeling with hepatectomy (1,2). It appears that laparoscopic hepatectomy has almost no restricted area. On one hand, surgeons are enjoying pushing ceaselessly the technique to the limits, which is promising; while on the other hand, the principle of the surgery for malignancies in this new era has less been focused and discussed thus far. According to the principles of oncological surgery, instead of the incision size or length of hospital stay, the most important indicator for evaluating the success and efficacy of malignant tumor treatment is the postoperative survival time. The King of the treatment for cancers is longer survival of the patients, that has never been or should be changed, and neither to be neglected. The surgical procedure can only be improved without compromising the postoperative survival time. Any minimal invasive technology that sacrificing long-term efficacy tends to bring more physical and psychological damage to patients. In clinical practice, recurrent cancer around liver resection margin shortly after laparoscopic hepatectomy is still seen. Therefore, the attitude towards minimally invasive surgeries requires more cautious under evidence-based medicine, avoiding any aggressive technological movements.
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