经括约肌间切除术围手术期肛门功能保护的关键点  

Critical techniques for anal function preservation during the perioperative period of intersphincteric resection

作　　者：潘宏锋 黄颖[1] Pan Hongfeng;Huang Ying(Department of Colorectal Surgery,Fujian Medical University Union Hospital,Fujian Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院结直肠外科,福建福州350001

出　　处：《腹部外科》2025年第2期99-104,117,共7页Journal of Abdominal Surgery

基　　金：福建省科技创新联合资金(2020Y9071)。

摘　　要：经括约肌间切除术作为低位直肠癌治疗的重要保肛术式,在确保肿瘤根治效果的同时显著提升了保肛成功率。该术式通过联合直肠切除与部分或全部肛门内括约肌切除,并实施超低位吻合重建,导致术后低位前切除综合征发生风险显著增加,表现为排便频次增加及急迫感等肠道功能障碍。近年来临床上日益重视低位前切除综合征的诊治与预防,但围手术期干预措施仍缺乏规范化管理方案。该文通过系统梳理现有研究证据,探讨经括约肌间切除术围手术期肛门功能保护的要点,以期为临床实践提供参考。Intersphincteric resection(ISR)has emerged as a pivotal sphincter-preserving procedure for low-level rectal cancer,demonstrating significant improvements in anal preservation rates while maintaining optimal oncological outcomes.This technique necessitates concomitant rectal resection with partial or complete internal anal sphincter excision,followed by ultra-low anastomotic reconstruction.This substantially elevates the risk of postoperative low anterior resection syndrome(LARS).Characterized by increased stool frequency,urgency,and bowel dysfunction,LARS has garnered escalating clinical attention in recent years.However,perioperative interventions for preventing and managing LARS remain inadequately standardized.This article systematically reviewed current evidence to elucidate critical technical elements for perioperative anal function preservation following ISR.

关 键 词：直肠癌 经括约肌间切除术 低位前切除综合征 围手术期 

分 类 号：R657.1[医药卫生—外科学]