[用于直肠癌的节保护手术 - - 从极限到完美]
1Department of Colorectal Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China.
概括
低直肠癌的关节保护手术平衡了瘤安全性和功能. 手术技术的进步和"观察和等待"策略提供了新的选择,免疫治疗有望改善结果.
科学领域:
- 结直肠癌手术 结直肠癌手术
- 在瘤学瘤学.
- 手术创新 在外科创新.
背景情况:
- 低直肠癌中关节的保存具有挑战性,需要对瘤生物学和盆腔解剖学的高级理解.
- 手术范式已经从彻底切除转变为优先考虑瘤安全和功能性保存.
研究的目的:
- 审查目前用于低直肠癌的关节保护疗法.
- 探索微创手术,非手术治疗和免疫疗法等新兴治疗方法的作用.
主要方法:
- 对外科手术技术的综述,包括低前切除 (LAR),间切除 (ISR) 和跨门全腹腔切除 (taTME).
- 讨论"观察和等待"策略作为非手术选择.
- 对特定患者群体的新辅助疗法结合免疫治疗的探索.
主要成果:
- 各种手术方法具有先进的关节保护能力.
- "观察和等待"战略为部分患者提供了非手术的方法.
- 免疫疗法与新辅助疗法相结合,有望改善pMMR/MSS患者的关节和器官保存率.
结论:
- 未来的关节保护治疗低直肠癌将以患者为中心,整合精准医学,多学科合作和人工智能.
- 目标是优化瘤安全和功能性保存之间的平衡.
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