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腹腔镜右半结肠癌根治术的标准化流程和质量控制

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腹腔镜右半结肠切除术是目前治疗右半结肠癌最常用的手术方式,其在手术切除范围、淋巴结清扫范围、消化道重建等关键技术上趋于成熟,但仍缺乏标准化的手术流程及质量控制体系.在COLOR Ⅳ研究(1项对比腹腔镜右半结肠癌根治术中腹腔内吻合与腹腔外吻合疗效的国际多中心随机对照研究)的前期筹备阶段,笔者团队基于德尔菲法调查结果制订腹腔镜右半结肠癌根治术标准化流程,形成手术能力及质量评估工具,目前正尝试利用人工智能实现该手术技能评价的自动化.笔者希望通过上述工作,帮助结直肠外科医师规范手术操作,减少手术并发症,为多中心临床研究的同质化提供支持,同时推动该手术结构化培训的实施.
Standardized procedures and quality control in laparoscopic right hemicolectomy for right-sided colon cancer
Laparoscopic right hemicolectomy is currently the most commonly used surgical procedure for right-sided colon cancer.Although this procedure is maturing in terms of key tech-niques such as the extent of surgical resection,the extent of lymph node dissection,and the recons-truction of digestive tract,it still lacks a standardized surgical procedure and quality control system.In the pre-preparation phase of the COLOR Ⅳ study(an international,multicenter,randomized contro-lled trail comparing the efficacy of intracorporeal anastomosis versus extracorporeal anasto-mosis in laparoscopic right hemicolectomy for right-sided colon cancer),the research team of the authors formulates a standardized procedure for laparoscopic right hemicolectomy based on the Delphi survey,and develops a competency assessment tool for surgical ability and quality.Attempts are being made to automate the evaluation of surgical techniques using artificial intelligence.It is hoped that the above work will help colorectal surgeons to standardize surgical operations and reduce complications,provide support for the homogenization of multicenter clinical studies,and promote the implementation of structured training for this procedure.

Colonic neoplasmsRight hemicolectomy for right-sided colon cancerSurgi-cal procedureStandardizationQuality controlCOLOR Ⅳ study

姚宏伟、魏鹏宇、舒文龙、吴偲、赵翰铮、宋建宁、吴国聪、张忠涛

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首都医科大学附属北京友谊医院普通外科 国家消化系统疾病临床医学研究中心 消化健康全国重点实验室首都医科大学结直肠肿瘤临床诊疗与研究中心,北京 100050

结肠肿瘤 右半结肠癌根治术 手术操作 标准化 质量控制 COLOR Ⅳ研究

国家重点研发计划北京市医院管理局临床医学发展专项(扬帆计划)首都医科大学结直肠肿瘤临床诊疗与研究中心专项北京市医院管理中心扬帆计划临床技术创新项目

2017YFC0110904ZYLX 2015041192070313ZLRK202302

2024

10.3760/cma.j.cn115610-20240507-00241

中华消化外科杂志
中华医学会

中华消化外科杂志

CSTPCD北大核心
影响因子：1.899
ISSN：1673-9752
年,卷(期)：2024.23(6)
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