腹腔镜低位直肠癌括约肌切除术的思考与展望

红红 郑(承德医学院附属医院，中国)
恩宏 赵(承德医学院附属医院，中国)

摘要

结直肠癌（CRC）是世界上常见的消化道恶性肿瘤，发病率在男性患者中居第 3 位、女性患者中居第 2 位，严重危害着人类健康。在中国，尤以低位直肠癌为主，约占直肠癌的 60%~75%。对于低位直肠癌常规选择腹会阴联合切除术（abdomino perineal resection，APR），但是患者需要承担永久性造口的痛苦。对胃肠外科医师来说，如何在肿瘤根治效果与保留肛门功能之间达到最佳平衡是目前研究的重点。腹腔镜 ISR 手术逐渐成为能为大多数患者提供肿瘤根治和保肛兼顾的手术模式。笔者通过查阅文献从 ISR 手术背景、手术适应症及术前评估、手术分型、手术微创化趋势及 ISR 术后肛门功能等五个方面展开综述。

关键词

低位直肠癌；腹腔镜；内括约肌切除术；保肛术 ；肛门功能

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DOI: http://dx.doi.org/10.26549/yzlcyxzz.v3i5.5253