rsjРоссийский хирургический журналRussian surgical journal3034-72703033-5604Фонд Алмазова10.18705/3034-7270-2025-1-4-69-78rsj-51Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯПути развития миниинвазивной хирургии колоректального рака (обзор литературы)Pathways of development in minimally invasive surgery for colorectal cancer (literature review)ЧерниковскийИ. Л.ChernikovskyI. L.

Черниковский Илья Леонидович – канд. мед. наук, заведующий хирургическим отделением онкоколопроктологии (хирургия, онкология)

Москва 

Chernikovsky Ilya L. – Candidate of Medical Sciences, Head of the Surgical Department of Oncocoloproctology (Surgery, Oncology)

Moscow 

odindra@mail.ruЧир-ЧирЭ. М.Chir-ChirE. M.

Чир-Чир Эмиль Марленович – врач-хирург, онколог хирургического отделения онкоколопроктологии (хирургия, онкология)

Москва 

Chir-Chir Emil M. – Surgeon, Oncologist of the Surgical Department of Oncocoloproctology (Surgery, Oncology)

Moscow 

surgeon.chirchir@gmail.comМосковская городская онкологическая больница № 62 департамента здравоохранения города МосквыРоссияMoscow City Oncological Hospital No. 62, Moscow Healthcare DepartmentRussian Federation202523122025146978Copyright © Черниковский И.Л., Чир-Чир Э.М., 20262026Черниковский И.Л., Чир-Чир Э.М.Chernikovsky I.L., Chir-Chir E.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsj.elpub.ru/jour/article/view/51

Колоректальный рак остается одной из наиболее значимых онкологических проблем. Хирургическое лечение является ключевым компонентом радикального лечения, а его развитие связано с внедрением и совершенствованием миниинвазивных технологий. В обзоре анализируются три основных направления улучшения результатов лечения колоректального рака: онкологические, непосредственные и функциональные результаты. Рассматривается эволюция от лапароскопии к роботической и трансанальной хирургии, обсуждаются преимущества и ограничения каждого метода, включая данные крупных рандомизированных исследований. Особое внимание уделено стратегиям снижения частоты несостоятельности анастомоза, таким как интраоперационная оценка перфузии с помощью индоцианина зеленого, интракорпоральное анастомозирование и минидоступы для извлечения препарата. Освещены современные подходы к органосохраняющим операциям при раке прямой кишки. Перспективы развития связываются с дальнейшей миниатюризацией, интеграцией искусственного интеллекта, умных инструментов и персонализацией хирургического лечения.

Colorectal cancer remains a major oncological challenge. Surgical intervention is a cornerstone of radical treatment, and its progress is closely linked to the adoption and refinement of minimally invasive techniques. This review analyzes three key areas for improving colorectal cancer treatment outcomes: oncological, perioperative, and functional results. It traces the evolution from laparoscopy to robotic and transanal surgery, discussing the advantages and limitations of each method, including data from major randomized trials. Special attention is paid to strategies for reducing anastomotic leak rates, such as intraoperative perfusion assessment with indocyanine green, intracorporeal anastomosis, and minimized specimen extraction incisions. Modern organ-preserving approaches for rectal cancer are also highlighted. Future directions are associated with further miniaturization, the integration of artificial intelligence, smart instruments, and the personalization of surgical care.

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The authors declare that there are no conflicts of interest present.