低位直肠癌经肛提肌外腹会阴联合切除术及盆底重建的手术要点  

Key techniques in extralevator abdominoperineal excision and pelvic floor repair for low rectal cancer

作　　者：蒋松松 陈刚[1] Jiang Songsong;Chen Gang(Department of General Surgery,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nan-jing 210008,Jiangsu,China)

机构地区：[1]南京大学医学院附属鼓楼医院普通外科,江苏南京210008

出　　处：《结直肠肛门外科》2022年第6期528-532,540,共6页Journal of Colorectal & Anal Surgery

基　　金：国家临床重点专科项目(卫办医政函[2012]649号)。

摘　　要：经肛提肌外腹会阴联合切除术(ELAPE)可获得无狭窄部位的圆柱状直肠癌手术标本,有利于降低环周切缘阳性率和局部复发率。但会阴部切除范围的扩大会导致盆底及会阴部并发症的发生率增高,因此盆底重建对于预防ELAPE术后会阴部并发症极为重要。本文结合笔者团队的手术经验,介绍低位直肠癌行ELAPE及盆底重建的手术要点,以期为临床医师提供参考,从而有助于降低ELAPE术后会阴部相关并发症的发生率。Extralevator abdominoperineal excision(ELAPE)can retrieve cylindrical rectal cancer surgical specimens without a“waist”,which is beneficial to reduce the positive rate of circumferential resection margin and local recurrence rate.However,the expansion of perineal resection will lead to an increased incidence of pelvic floor and perineal complications.Therefore,pelvic floor reconstruction is crucial in preventing perineal complications after ELAPE.In this paper,based on our experiences,we introduce the key techniques in ELAPE and pelvic floor reconstruction for low rectal cancer to provide references for our peers and reduce the incidence of perineal complications after ELAPE.

关 键 词：低位直肠癌 经肛提肌外腹会阴联合切除术 盆底重建 术后并发症 

分 类 号：R735.37[医药卫生—肿瘤]