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摘要:
我国结直肠外科手术技术发展迅猛, 但在专科化建设、诊疗规范化、临床研究的开展等方面仍落后于西方发达国家。因此, 我国结直肠外科未来应重点加强专科化建设, 提高结直肠疾病诊断和治疗的规范化程度, 推广结直肠外科手术的标准化和微创化; 更为重要的是, 应在全国性学术机构的组织下, 开展基于中国结直肠疾病患者的外科相关临床研究, 并获得高级别"循证医学"证据, 形成中国结直肠疾病的外科治疗相关指南, 用于指导我国结直肠疾病诊疗的外科临床实践。中国结直肠外科的未来发展任重而道远。
Abstract:The surgical technique of colorectal surgery in China is developing rapidly, but it is far behind the western countries in the fields of specialization, standardization of diagnosis and treatment, clinical research and so on. Therefore, in the future, we should focus on strengthening the specialization of colorectal surgery, improving the standardization of diagnosis and treatment of colorectal diseases, boosting the standardization of colorectal surgery, and promoting application of minimally invasive surgery. More importantly, it's time to figure out how to conduct the surgical research related to Chinese patients with colorectal disease under the organization of national academic institutions, and obtain high-level "evidence-based medicine" research to form Chinese guidelines for surgical treatment of colorectal diseases. These guidelines can be used for surgical management of colorectal disease in China. Colorectal surgeons in China still have a long way to achieve the above-mentioned objectives.
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[1] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016[J]. CA Cancer J Clin, 2016, 66:7-30. doi: 10.3322/caac.21332 [2] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66:115-132. doi: 10.3322/caac.21338 [3] Edge SB, Byrd DR, Compton CC, et al. AJCC Cancer Staging Manual[M].7th ed.New York:Springer, 2010:143-164. [4] Amin MB, Greene FL, Edge S, et al. AJCC Cancer Staging Manual[M].8th ed. New York:Springer, 2016:252-274. [5] 刘荫华, 姚宏伟, 周斌, 等.美国肿瘤联合会结直肠癌分期系统(第8版)更新解读[J].中国实用外科杂志, 2017, 37:6-9. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgsywkzz201701003 [6] Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery-the clue to pelvic recurrence?[J]. Br J Surg, 1982, 69:613-616. doi: 10.1002/bjs.1800691019 [7] Hohenberger W, Weber K, Matzel K, et al. Standardized surgery for colonic cancer:complete mesocolic excision and central ligation-technical notes and outcome[J]. Colorectal Dis, 2009, 11:354-364. doi: 10.1111/j.1463-1318.2008.01735.x [8] Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer[J]. N Engl J Med, 2004, 350:2050-2059. doi: 10.1056/NEJMoa032651 [9] Jayne DG, Guillou PJ, Thorpe H, et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma:3-year results of the UK MRC CLASICC Trial Group[J]. J Clin Oncol, 2007, 25:3061-3068. doi: 10.1200/JCO.2006.09.7758 [10] Buunen M, Veldkamp R, Hop WC, et al. Survival after laparoscopic surgery versus open surgery for colon cancer:long-term outcome of a randomised clinical trial[J]. Lancet Oncol, 2009, 10:44-52. doi: 10.1016/S1470-2045(08)70310-3 [11] Bonjer HJ, Deijen CL, Abis GA, et al. A randomized trial of laparoscopic versus open surgery for rectal cancer[J]. N Engl J Med, 2015, 372:1324-1332. doi: 10.1056/NEJMoa1414882 [12] Jeong SY, Park JW, Nam BH, et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial):survival outcomes of an open-label, non-inferiority, randomised controlled trial[J]. Lancet Oncol, 2014, 15:767-774. doi: 10.1016/S1470-2045(14)70205-0 [13] Fleshman J, Branda M, Sargent DJ, et al. Effect of laparoscopic-assisted resection vs open resection of stage Ⅱ or Ⅲ rectal cancer on pathologic outcomes:The ACOSOG Z6051 Randomized Clinical Trial[J]. JAMA, 2015, 314:1346-1355. doi: 10.1001/jama.2015.10529 [14] Stevenson AR, Solomon MJ, Lumley JW, et al. Effect of laparoscopic-assisted resection vs open resection on pathological outcomes in rectal cancer:The ALaCaRT Randomized Clinical Trial[J]. JAMA, 2015, 314:1356-1363. doi: 10.1001/jama.2015.12009 [15] Whitehouse M. A policy framework for commissioning cancer services[J]. BMJ, 1995, 310:1425-1426. doi: 10.1136/bmj.310.6992.1425 [16] 姚宏伟, 修典荣, 付卫, 等.多学科协作诊治团队模式治疗可切除的结直肠癌肝转移[J].中华外科杂志, 2012, 50:961-965. doi: 10.3760/cma.j.issn.0529-5815.2012.11.001 [17] 中华医学会消化病学分会胃肠动力学组, 中华医学会外科学分会结直肠肛门外科学组.中国慢性便秘诊治指南(2013年, 武汉)[J].中华消化杂志, 2013, 33:291-297. doi: 10.3760/cma.j.issn.0254-1432.2013.05.002 [18] Heald RJ. A new solution to some old problems:transanal TME[J]. Tech Coloproctol, 2013, 17:257-258. doi: 10.1007/s10151-013-0984-0 [19] Cancer Genome Atlas Network. Comprehensive molecular characterization of human colon and rectal cancer[J]. Nature, 2012, 487:330-337. doi: 10.1038/nature11252 [20] Guinney J, Dienstmann R, Wang X, et al. The consensus molecular subtypes of colorectal cancer[J]. Nat Med, 2015, 21:1350-1356. doi: 10.1038/nm.3967 [21] Ye LC, Liu TS, Ren L, et al. Randomized controlled trial of cetuximab plus chemotherapy for patients with KRAS wild-type unresectable colorectal liver-limited metastases[J]. J Clin Oncol, 2013, 31:1931-1938. doi: 10.1200/JCO.2012.44.8308 [22] Deng Y, Chi P, Lan P, et al. Modified FOLFOX6 with or without radiation versus fluorouracil and leucovorin with radiation in neoadjuvant treatment of locally advanced rectal cancer:initial results of the Chinese FOWARC multicenter, open-label, randomized three-arm Phase Ⅲ Trial[J]. J Clin Oncol, 2016, 34:3300-3307. doi: 10.1200/JCO.2016.66.6198
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