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大规模的临床研究显示,传统直肠癌腹会阴联合切除术[abdominoperineal excision,APE;或称为abdominalperineal resection(APR)]环周切缘(circumferencial resection margin,CRM)阳性率较高和手术中穿孔率较高是其术后局部复发率高和病人存活率低的重要原因。因此,其作为不能保留肛门的低位直肠癌的手术治疗金标准逐渐受到挑战。直肠癌柱状腹会阴联合切除(cylindrical abdominoperineal excision,CAPE)即直肠癌肛提肌外腹会阴联合切除(extral levator abdominoperineal excision,ELAPE)手术能够显著降低直肠癌手术后环周切缘阳性率及局部复发率,且不增加手术打击,使其可能成为传统APE以外的一个新选择。应进一步验证该手术的长期疗效和病人生活质量,同时应制订手术规范,更好地保护植物神经和采用个体化的手术方案。
Large-scale clinical studies have shown that the high positive rate of conventional rectal cancer periopexy resection (APE; or abdominal perineal resection (APR)] circumflex margin resection (CRM) and perforation rate High is its postoperative local recurrence rate and the low survival rate of the important reasons. Therefore, it is gradually challenged as the gold standard for surgical treatment of low rectal cancer that can not retain the anus. Rectal cancer with cylindrical abdominoperineal excision (CAPE), an extral levator abdominoperineal excision (ELAPE), can significantly reduce the positive rate of peri-operative margins and local recurrence after rectal cancer surgery Rate, and does not increase the surgery hit, making it may become a new alternative to the traditional APE. Should further verify the long-term efficacy of the operation and patient quality of life, and should develop surgical specifications, better protection of autonomic and the use of individualized surgical options.