锁孔手术

锁孔手术具有缩小手术创口大小的益处，从而可以减少美观方面的困扰并且减少病人的疼痛。这使患者由于疼痛减少可以尽早活动，从而尽早恢复正常生活包括尽早返回工作岗位。

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术创口产生

锁孔（内窥镜）手术现在已经在多次随机对照试验[1-8]中显示对于结肠癌手术的使用是安全的。大量随机对照试验及大规模回顾研究[9]都十分类似，已经证明其对于直肠癌手术具有益处。两个大型澳大利亚研究已经显示该手术方法对于结直肠癌症的安全性，并且对于年幼及年老患者的益处[10-11]。

机器人手术是一种新兴技术，结合了微创手术及只有机器人才能提供的高度精密准确性。该方法最为有用的应用是针对那些位于骨盆较低处的手术，使其尤其适合用于低位直肠癌症手术。该方法提供腹腔镜手术的诸多益处，并且还改善操控性从而实现更好的切除边缘，带来更少的失血。

参考表

  1. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 2005;365:1718-1726.

  2. Araujo SE, da Silva eSousa AH Jr, dr Campos FG, et al. Conventional approach laparoscopic abdominoperineal resection for rectal cancer treatment after neoadjuvant chemoradiation: results of a prospective randomized trial. Rev Hosp Clin Fac Med Sau Paulo. 2003;58:133-40.

  3. Ng SS, Leung KL, Lee JF, et al. Laparoscopic-assisted versus open abdominoperineal resection for low rectal cancer: a prospective randomized trial. Ann Surg Oncol 2008;15:2418-2425.

  4. Leung KL, Kwok SP, Lam SC, et al. Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 2004;363:1187-1192.

  5. Kang S et al. Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol 2010;11:637-645.

  6. Zhou Z, Hu M, Li Y, et al. Laparoscopic vs open total mesorectal excision with anal sphincter preservation for low rectal cancer. Surg Endosc 2004;18:1211-1215.

  7. Braga M, Frasson M, Vignali A, et al. Laparoscopic resection in rectal cancer patients: outcome and cost-benefit analysis. Dis Colon Rectum 2007;50:464-471.

  8. Lujan J, Valero G, Hernandez Q, et al. Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer. Br J Surg 2009;96:982-989.

  9. Breukink S, Pierie J-P, Wiggers T. Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD005200. DOI: 10.1002/14651858.CD005200.pub2.

  10. Allardyce RA, Bagshaw PF, Frampton CM, et al. The Australasian laparaoscopic colon cancer study. ANZ J Surg. 2008;78:832–833.

  11. McKay GD, Morgan MJ, Wong SKC, et al. Improved Short-term Outcomes of Laparoscopic versus Open Resection for Colon and Rectal Cancer in an Area Health Service: A Multicentre Study. Diseases of the Colon & Rectum 2012: 55(1); page 42-50.