摘要
对于距离肛缘<5 cm的低位直肠癌,传统的腹会阴联合切除术常不得不牺牲肛门以保证根治手术的彻底性.近20年来随着保留肛门括约肌手术的进展,尤其是经括约肌间切除术(intersphincteric resection,ISR)的推广,在保证低位直肠肿瘤根治性切除同时成功实现了保肛.因此,低位直肠癌选择传统腹会阴联合切除术的比率逐渐下降.国内外许多学者围绕该手术的适应证、疗效、术后控便功能等进行了研究,相关循征数据相继报道.同时,也有一些问题仍有待更多的研究来明确.本文对ISR保肛手术的适应证选择、肿瘤学结果、功能性结果和手术相关问题进行探讨.
For low rectal cancer located 5 cm from the anal verge,abdominoperineal resection（APR）with permanent sigmoid colostomy is usually used to ensure the RO resection.Sphincter saving surgery has emerged in the last 20 years,and the introduction of intersphincteric resection（ISR） can successfully preserve the anal function and guarantee a radical tumor resection for patients with ultra-low lying tumors.Therefore,the use of APR has been consistently declining worldwide.Recently,a growing body of research on ISR has been reported.However,more evidence based results are needed to clarify some issues about ISR.In the current review,we discuss the indications for ISR and the oncological and functional outcomes following the procedure.Some technique issues of ISR are also discussed.
出处
《世界华人消化杂志》
CAS
2016年第26期3764-3771,共8页
World Chinese Journal of Digestology
基金
首都临床特色应用研究基金资助项目
No.Z151100004015013~~
