1.4 小结
综上所述，近年来，随着对解剖学和肿瘤学理论的不断深入研究以及腹腔镜手术器械的更新换代，结肠癌外科治疗日益微创化、精准化，手术规范和根治程度也不断提升。同时，随着分子机制基础研究的发展和新的药物的临床应用，局部进展期结肠癌围手术期综合治疗的手段不断丰富，根据治疗目标和精准分期指导下的右半结肠癌外科治疗已经进入了新的时代。根据现有的临床问题和争议，新的RCT 研究和高级别循证医学证据将有助于右半结肠癌治疗的进一步的规范和提高。
（李心翔、李大卫）
参考文献
[1]JACOBS M,VERDEJA J C,GOLDSTEIN H S.Minimally invasive colon resection (laparoscopic colectomy)[J].Surg Laparosc Endosc,1991,1(3):144-150.
[2]NELSON H,SARGENT D,WIEAND H S.Clinical Outcomes of Surgical Therapy Study Group.A comparison of laparoscopically assisted and open coloectomy for colon cancer[J].N Engl J Med,2004,350: 2050-2059.
[3]JAYNE D G,GUILLOU P J,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(21):3061-3068.
[4]Colon Cancer Laparoscopic or Open Resection Study Group,BUUNEN M,VELDKAMP R,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(1):44-52.
[5]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(4):354-364.
[6]ZURLENI T,CASSIANO A,GJONI E,et al.Surgical and oncological outcomes after complete mesocolic excision in right-sided colon cancer compared with conventional surgery: a retrospective,single-institution study[J].Int J Colorectal Dis,2018,33(1):1-8.
[7]AN M S,BAIK H,OH S H,et al.Oncological outcomes of complete versus conventional mesocolic excision in laparoscopic right hemicolectomy[J].ANZ J Surg,2018,88(10):E698-E702.
[8]ALHASSAN N,YANG M,WONG-CHONG N,et al.Comparison between conventional colectomy and complete mesocolic excision for colon cancer: a systematic review and pooled analysis : A review of CME versus conventional colectomies[J].Surg Endosc,2019,33(1):8-18.
[9]ATHANASIOU C D,MARKIDES G A,KOTB A,et al.Open compared with laparoscopic complete mesocolic excision with central lymphadenectomy for colon cancer: a systematic review and meta-analysis[J].Colorectal Dis,2016,18(7):224-235.
[10]KIM I Y,KIM B R,CHOI E H,et al.Short-term and oncologic outcomes of laparoscopic and open complete mesocolic excision and central ligation[J].Int J Surg,2016,27:151-157.
[11]FLESHMAN J,SARGENT D J,GREEN E,et al.Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial[J].Ann Surg,2007,246(4):655-662.
[12]DEIJEN C L,VASMEL J E,dE LANGE-DE KLERK E S M,et al.Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer[J].Surg Endosc,2017,31(6):2607-2615.
[13]JAYNE D G,THORPE H C,COPELAND J,et al.Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer[J].Br J Surg,2010,97(11):1638-1645.(https://www.daowen.com)
[14]LIU Q,LUO D,LIAN P,et al.Reevaluation of laparoscopic surgery's value in pathological T4 colon cancer with comparison to open surgery: A retrospective and propensity score-matched study[J].Int J Surg,2018,53:12-17.
[15]LIU Q,LUO D,LIAN P,et al.Reevaluation of laparoscopic surgery's value in pathological T4 colon cancer with comparison to open surgery: A retrospective and propensity score-matched study[J].Int J Surg.2018,53:12-17.
[16]YAMANASHI T,NAKAMURA T,SATO T,et al.Laparoscopic surgery for locally advanced T4 colon cancer: the long-term outcomes and prognostic factors[J].Surg Today,2018,48(5):534-544.
[17]SHUKLA P J,TRENCHEVA K,MERCHANT C,et al.Laparoscopic resection of t4 colon cancers: is it feasible[J].Dis Colon Rectum,2015,58(1):25-31.
[18]KLAVER C E L,KAPPEN T M,BORSTLAP W A A,et al.Laparoscopic surgery for T4 colon cancer: a systematic review and meta-analysis[J].Surg Endosc,2017,31(12):4902-4912.
[19]YAMAMOTO S,INOMATA M,KATAYAMA H,et al.Short-term surgical outcomes from a randomized controlled trial to evaluate laparoscopic and open D3 dissection for stage II/III colon cancer: Japan Clinical Oncology Group Study JCOG 0404[J].Ann Surg,2014,260(1):23-30.
[20]AN M S,BAIK H,OH S H,et al.Oncological outcomes of complete versus conventional mesocolic excision in laparoscopic right hemicolectomy[J].ANZ J Surg,2018,88(10):E698-E702.
[21]OUYANG M,LUO Z,WU J,et al.Comparison of outcomes of complete mesocolic excision with conventional radical resection performed by laparoscopic approach for right colon cancer[J].Cancer Manag Res,2019,11:8647-8656.
[22]BAE S U,SAKLANI A P,LIM D R,et al.Laparoscopic-assisted versus open complete mesocolic excision and central vascular ligation for right-sided colon cancer[J].Ann Surg Oncol,2014,21(7):2288-2294.
[23]CHAOUCH M A,DOUGAZ M W,BOUASKER I,et al.Laparoscopic Versus Open Complete Mesocolon Excision in Right Colon Cancer: A Systematic Review and Meta-Analysis[J].World J Surg,2019,43(12):3179-3190.
[24]SHIN J K,KIM H C,LEE W Y,et al.Laparoscopic modified mesocolic excision with central vascular ligation in right-sided colon cancer shows better short- and long-term outcomes compared with the open approach in propensity score analysis[J].Surg Endosc,2018,32(6):2721-2731.
[25]WATANABE T,ITABASHI M,SHIMADA Y,et al.Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer[J].Int J Clin Oncol,2012,17(1):1-29.
[26]SφNDENAA K,QUIRKE P,HOHENBERGER W,et al.The rationale behind complete mesocolic excision (CME) and a central vascular ligation for colon cancer in open and laparoscopic surgery : proceedings of a consensus conference[J].Int J Colorectal Dis,2014,29(4):419-428.
[27]孙跃明.腹腔镜右半结肠癌根治术难点与关键技术[J].中华普外科手术学杂志（电子版），2017，02：102-104.
[28]VIGNALI A,GHIRARDELLI L,DI PALO S,et al.Laparoscopic treatment of advanced colonic cancer: a case-matched control with open surgery[J].Colorectal Dis,2013,15(8):944-948.
[29]ADINA E.FEINBERG,TYLER R.et al.Oncologic Outcomes Following Laparoscopic versus Open Resection of pT4 Colon Cancer: A Systematic Review and Meta-analysis[J].Diseases of the Colon & Rectum,2017,60(1):116-125.