Abstract:

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)