经前会阴平面超低位直肠前切除技术在腹腔镜直肠癌根治术中的应用  

Laparoscopic anterior perineal plane for ultra-low anterior resection of the rectum for low rectal cancer

作　　者：童卫东[1] 赵松[1] 赵俊胜[2] 刘宝华[1] 郑湖玲[1] 张鑫[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所胃结直肠外科,重庆400042 [2]解放军第三二四医院,重庆400020

出　　处：《中华消化外科杂志》2012年第3期231-234,共4页Chinese Journal of Digestive Surgery

基　　金：重庆市自然科学基金（CSTC.2008BB5277）

摘　　要：得益于吻合器的广泛应用和基于病理学研究对直肠癌远端切除范围的再认识，保留肛门括约肌的低位直肠癌根治手术在近10余年取得了突破性的进展。但由于肿瘤本身的特点（如位置低、体积大、分化差等）或肥胖、手术技术等原因，仍然有近30％的患者需要行永久性的结肠造口术。The introduction of stapling instruments and improved understanding of pathology has resulted in a greater proportion of low rectal cancer patients undergoing sphincter-pre- serving resection. A variety of alternative techniques have been proposed to avoid a permanent stoma, including abdominal pull through, abdominal trans-sphincteric resection and intersphinc-teric resection. However, these damages always inflicted on the anal sphincters with poor functional results. More recently, the anterior perineal plane for ultra-low anterior resection of the rec- tum （APPEAR） technique was developed which approaches the anorectum via an anterior transperineal approach and exploits an anatomic space within the pelvic floor musculature termed ＂rectal no-man＇s land＂. The ability to access this segment of distal rectum by the perineal approach may determine whether a sphincter-saving resection can be performed for a proportion of patients who would otherwise require a permanent stoma. We performed laparoscopic APPEAR for a 46-year old woman with low rectal cancer with satisfactory results.

关 键 词：直肠肿瘤 腹腔镜检查 经前会阴平面超低位直肠前切除 

分 类 号：R735.37[医药卫生—肿瘤]