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长久以来,低位直肠癌的手术治疗采用的是腹会阴联合切除术,但该术式易导致永久性的穿孔,且不能达到明确的局部控制效果。过去20年里,保肛手术问世,其可以治疗外括约肌未受累及的低位直肠癌患者。经内外括约肌间切除术(ISR)从内、外肛门括约肌间开始手术,行直肠远端切除。ISR最初叫开放手术,随着腹腔镜技术的发展而发展。为保证肿瘤学和功能效果,必须严格掌握ISR的手术适应证。常通过MRI检查所示的肛缘距肿瘤距离来确定清扫范围和内括约肌切除范围,因此
For a long time, surgical treatment of low rectal cancer using abdominal perineal resection, but the operation is easy to cause permanent perforation, and can not achieve a clear local control effect. During the past two decades, sphincter preserving surgery has been developed to treat patients with low rectal cancer who are not involved in the external sphincter. Internal and external sphincterotomy (ISR) from the internal and external anal sphincter between the surgery, distal resection of the rectum. ISR was originally called open surgery, with the development of laparoscopic technology. To ensure oncology and functional effects, we must strictly control the ISR surgical indications. Often by MRI examination of the anal margin from the tumor to determine the scope of the cleaning and the scope of the internal sphincter resection