单孔+1腹腔镜手术在结直肠癌根治术中的应用与探索
Application and exploration of single-incision plus one port laparoscopic surgery in radical resection of colorectal cancer
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摘要: 结直肠癌的外科治疗方式已从传统多孔腹腔镜手术逐渐向更为微创化与个体化的手术模式转变,其中单孔腹腔镜手术(SILS)及减孔腹腔镜手术(RPLS)受到越来越多临床医师的关注。单孔+1腹腔镜手术(SILS+1)融合了SILS与RPLS的双重优势,近年的研究已证实其在治疗结肠癌方面与传统多孔腹腔镜手术相比,具有相似的有效性、安全性以及肿瘤学疗效,同时在快速康复和美容效果方面更具优势。SILS+1的发展与单孔平台装置和器械的不断进步密切相关。在严格把握SILS+1手术适应证的前提下,术中巧妙利用悬吊及牵拉技巧,规范处理出血等并发症,可使手术过程安全、顺畅。笔者查阅国内外相关研究并结合团队的实践经验,深入探讨SILS+1在结直肠癌根治术中的应用与探索,旨在为该手术方式的进一步推广提供有价值的参考依据。Abstract: The surgical management of colorectal cancer has evolved from conventional multiport laparoscopic surgery toward more minimally invasive and individualized approaches. Among these, single-incision laparoscopic surgery (SILS) or reduced-port laparoscopic surgery (RPLS) has gained increasing attention from clinicians. Single-incision plus one port laparoscopic surgery (SILS+1) combines the advantages of both SILS and RPLS. Recent studies have demonstrated that compared with conventional multiport laparoscopic surgery, SILS+1 could yield comparable safety, feasibility and oncologic outcomes in treating colorectal cancer while offering additional benefits in enhanced recovery and better cosmesis.The development of SILS+1 relies heavily on innovations in single-port platforms and specialized instruments. By strictly adhering to its indica-tions, skillfully employing string and traction techniques during surgery, and the appropriate mana-gement of complications such as hemorrhage, the procedure can be performed safely and smoothly. The authors review relevant domestic and international studies and integrate the practical experi-ence to provide an in-depth discussion on the application and exploration of SILS+1 in radical colorectal cancer surgery, aiming to provide valuable insights for broader adoption of this approach.