1、1直肠癌肿瘤分期与手术方式10/12/2022Haggitts分类法分类法SM分级分级2直肠癌肿瘤分期与手术方式10/12/20223直肠癌肿瘤分期与手术方式10/12/20224直肠癌肿瘤分期与手术方式10/12/20225直肠癌肿瘤分期与手术方式10/12/20226直肠癌肿瘤分期与手术方式10/12/20227直肠癌肿瘤分期与手术方式10/12/20228直肠癌肿瘤分期与手术方式10/12/20229直肠癌肿瘤分期与手术方式10/12/202210直肠癌肿瘤分期与手术方式10/12/202211直肠癌肿瘤分期与手术方式10/12/202212直肠癌肿瘤分期与手术方式10/12/20221
2、3直肠癌肿瘤分期与手术方式10/12/202214直肠癌肿瘤分期与手术方式10/12/202215直肠癌肿瘤分期与手术方式10/12/202216直肠癌肿瘤分期与手术方式10/12/202217直肠癌肿瘤分期与手术方式10/12/202218直肠癌肿瘤分期与手术方式10/12/2022Lacy AM,GarciaVa ldecasas JC,De lgado S,et a.l Laparoscopic assisted colectomy vs open colectomy for treatment of nonmetastatic colon cancer:a random ized tr
3、ial J.Lancet,2002,359(9325):2224-224919直肠癌肿瘤分期与手术方式10/12/202220直肠癌肿瘤分期与手术方式10/12/2022远期疗效，5年生存率及无复发生存率与开腹手术相同近期效果，腹腔镜手术和开腹手术无差别21直肠癌肿瘤分期与手术方式10/12/2022COLOR研究Buunen M,Veldkamp R,et al.Survival after laparoscopic surgery versus open surgery for colon cancer:long-term outcome of a randomised clinical
4、trial.Lancet Oncol.2009 Jan;10(1):44-52.Epub 2008 Dec 13Open colectomyLaparoscopic colectomyDifferenceDisease-free survival3 years76.2(72.6-79.8)74.2(70.4-78.0)2.0(-3.2 to 7.2)5 years67.9(63.6-72.2)66.5(62.2-70.7)1.4(-4.6 to 7.5)Overall Survival3 years84.2(81.1-87.3)81.8(78.4-85.1)2.4(-2.1 to 7.0)5
5、years74.2(70.1-78.2)73.8(69.7-77.9)0.4(-5.3 to 6.1)Data given are percentages(95%CI)Table 4:Survival at 3 and 5 years according to procedure.22直肠癌肿瘤分期与手术方式10/12/2022COLOR研究Buunen M,Veldkamp R,et al.Survival after laparoscopic surgery versus open surgery for colon cancer:long-term outcome of a random
6、ised clinical trial.Lancet Oncol.2009 Jan;10(1):44-52.Epub 2008 Dec 13Cancer recurrence or death from any cause(DFS)Overall mortality(OS)HR(95%CI)P valueHR(95%CI)P valueProcedureOpen vs Laparoscopic colectomy0.93(0.74-1.15)0.490.95(0.74-1.22)0.70Stage vs 1.29(.093-1.79)0.131.13(0.77-1.65)0.53 vs 2.6
7、4(1.92-3.63)0.0012.60(1.82-3.71)0.001SexWomen vs men0.81(0.65-1.01)0.060.67(0.52-0.86)0.002AgePer 10-year increase1.42(1.27-1.59)0.0011.80(1.57-2.06)0.001Reference categories for the categorical variables are laparoscopy procedures,stage disease,and male sex.Table 5:Multivariable analysis(Cox-regres
8、sion)of disease-free survival(DFS)and overall survival(OS)according to various factors.23直肠癌肿瘤分期与手术方式10/12/202224直肠癌肿瘤分期与手术方式10/12/202225直肠癌肿瘤分期与手术方式10/12/202226直肠癌肿瘤分期与手术方式10/12/2022机器人27直肠癌肿瘤分期与手术方式10/12/2022机器人28直肠癌肿瘤分期与手术方式10/12/2022借助机械臂和3D显像系统可以完成微创微创机器手臂比人手更能获得稳定的效果，以及有效的滤过生理震颤操作精细稳定高清3D显示技术还原一个真实的手术视野，计算机数码放大功能使精细操作成为可能图像清晰稳定机器人29直肠癌肿瘤分期与手术方式10/12/202230直肠癌肿瘤分期与手术方式10/12/202231直肠癌肿瘤分期与手术方式10/12/2022
