柱状（经肛提肌外）腹会阴联合切除术治疗低位进展期直肠癌  

Research progress of cylindrical abdominoperineal resection/extralevator abdominoperineal excision foradvanced low rectal cancer

作　　者：王振军[1] 韩加刚[1] 

机构地区：[1]首都医科大学附属北京朝阳医院普通外科,100020

出　　处：《中华胃肠外科杂志》2012年第10期1013-1016,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金主任基金（81141025）：北京市卫生系统领军人才（2009-1-03）;新世纪百千万人才工程（09-9ll一002;08-009）;首都医学发展科研基金（2009-3109）

摘　　要：针对传统腹会阴联合切除术治疗卣肠癌术后局部复发率较高的缺点．近年来提出了柱状腹会阴联合切除术（CAPR）的手术方法，也称为经肌提肌外腹会阴联合切除术。从目前研究来看，该术式可以降低直肠癌手术的环周切缘阳性率和肿瘤穿孔率，降低术后局部复发牢，从而可能提高患各的生存率。随着研究的深入，出现了一些热点问题，如盆底的重建方法、会阴部手术操作的体位、腹腔镜技术的联合应用、术后的会阴疼痛以及术后泌尿生殖神经损伤的并发症等。在临床实践和解剖学研究的基础上提出的个体化CAPR技术有望在保证根治性的前提下，减少患者创伤，降低术后并发症的发生。Cylindrical abdominoperineal resection （CAPR）, also known as extralevator abdominoperineal excision （ELAPE）, has been described as a method for improving the outcome of APR for advanced low reetal eaneer, probably because of more pelvic dissection and less positive cireumferential resection margin （CRM）. Recently, there have been some hot issues associated with CAPR/EIAPE, such as pelvic＇, floor reconstruction methods, prone or lithotomy positioning during pelvic procedure, postoperative chronic perineal pain, posloperalive sexual and urinary nerves damage,etc. Individual eylindric, al procedure based on clinical and anatomic research may be as effective as CAPR/ELAPE while minimizing the operative trauma antt the damage to the nerves of the genital and urinary organs.

关 键 词：直肠肿瘤 柱状腹会阴联合切除术 经肛提肌外腹会阴联合切除术 植物神经保护 个体化治疗 并发症 

分 类 号：R735.37[医药卫生—肿瘤]