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腹腔镜中低位直肠癌手术的技术安全性和可行性得到了大量临床研究的证实,其术后恢复快、疼痛轻、住院时日短等微创意义日趋明显。腹腔镜下可以严格遵守全直肠系膜切除和肿瘤学原则,保证了肿瘤学安全性。腹腔镜应用于新辅助放化疗直肠癌的安全性也得到了初步论证,在肛门括约肌保留和术后性功能及排尿功能影响等方面可能较开腹更有优势。最新的临床研究结果肯定了腹腔镜在中低位直肠癌外科治疗中的应用价值,显示了乐观的前景,但其临床应用仍需多中心前瞻性随机对照研究数据的支持。
The technical safety and feasibility of laparoscopic surgery for low and middle rectal cancer have been confirmed by a large number of clinical studies. The quick recovery after surgery, less pain, shorter hospitalization and other minimally invasive meanings have become increasingly apparent. Laparoscopic strict adherence to total mesorectal excision and oncology principles to ensure oncology safety. The safety of laparoscopy in neoadjuvant chemoradiotherapy and rectal cancer has also been preliminarily demonstrated. It may be more advantageous than laparotomy in retention of anal sphincter and postoperative sexual function and urinary function. The latest clinical results confirm the value of laparoscopy in the surgical treatment of low and middle rectal cancer, showing optimistic prospects, but its clinical application still need multi-center prospective randomized controlled data.