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中华结直肠疾病电子杂志

中华结直肠疾病电子杂志 ›› 2024, Vol. 13 ›› Issue (02) : 141 -147. doi: 10.3877/cma.j.issn.2095-3224.2024.02.008

综述

腹腔镜超低位直肠癌适形保肛手术的研究进展
刘腾1, 刘萍1,†(), 仁永平1, 吕琼1, 吕倩婷1   
  1. 1. 650118　昆明医科大学第三附属医院结直肠外科
  • 收稿日期:2024-01-15 出版日期:2024-04-25
  • 通信作者: 刘萍
  • 基金资助:
    云南省科技厅科技计划项目(202201AY070001-134)

Research progress in laparoscopic conformal sphincter-preserving operation for low rectal cancer

Teng Liu1, Ping Liu1,†(), Yongping Ren1, Qiong Lv1, Qianting Lv1   

  1. 1. Department of Colorectal Surgery, third Affiliated Hospital of Kunming Medical University, Yunnan 650118, China
  • Received:2024-01-15 Published:2024-04-25
  • Corresponding author: Ping Liu
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刘腾, 刘萍, 仁永平, 吕琼, 吕倩婷. 腹腔镜超低位直肠癌适形保肛手术的研究进展[J]. 中华结直肠疾病电子杂志, 2024, 13(02): 141-147.

Teng Liu, Ping Liu, Yongping Ren, Qiong Lv, Qianting Lv. Research progress in laparoscopic conformal sphincter-preserving operation for low rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(02): 141-147.

近年来，随着经括约肌间切除术（ISR）的出现和应用，众多的超低位直肠癌患者获得保肛可能。但ISR术所带来的一系列肛门结构损伤严重影响了患者的生活质量。由张卫教授团队提出的超低位直肠癌适形保肛手术（CSPO）也叫“改良的部分ISR”：以肿瘤远端1 cm作为肿瘤侧切除线，以高于肿瘤侧切除线2 cm~3 cm作为肿瘤对侧切除线，利用对侧多保留的肠璧与近端肠管吻合，可以更好的保留肛门功能。本文针对腹腔镜超低位直肠癌CSPO研究进展，对超低位直肠癌CSPO手术的产生背景、解剖学基础、适应证与禁忌证、术前评估方式、腹腔镜条件下手术操作要点、与其他术式对比、手术并发症的预防及处理进行全面系统介绍，为超低位直肠癌CSPO的推广进一步提供文献支持。同时对超低位直肠癌的治疗前景进行展望。

关键词: 直肠, 超低位直肠癌, 保肛手术, 适形保肛手术（超低位直肠癌CSPO）, 经括约肌间切除术（ISR）

In recent years, with the emergence and application of intersphincter resection (ISR), many patients with ultra-low rectal cancer have obtained the possibility of preserving their anus. However, the series of anal structural injuries caused by ISR surgery seriously affect the quality of life of patients. The conformal sphincter-preserving operation (CSPO) proposed by Professor Zhang Wei's team for ultra-low rectal cancer, also known as the "improved partial ISR", uses 1 cm at the distal end of the tumor as the tumor side resection line, 2 cm-3 cm above the tumor side resection line as the tumor contralateral resection line, and utilizes the reserved intestinal wall on the opposite side to anastomose with the proximal intestinal canal, which can better preserve anal function. This article focuses on the research progress of laparoscopic CSPO for ultra-low rectal cancer. It provides a comprehensive and systematic introduction to the background, anatomical basis, indications and contraindications, preoperative evaluation methods, key surgical points under laparoscopic conditions, comparison with other surgical methods, prevention and management of surgical complications, and further provides literature support for the promotion of CSPO. At the same time, the treatment prospects of ultra-low rectal cancer are prospected.

Key words: Rectum, Ultra low rectal cancer, Anal preservation surgery, Conformal sphincter-preserving operation(CSPO), Intersphincter resection(ISR)
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