经腹会阴联合切除术的回顾与发展

doi:10.6040/j.issn.1671-7554.0.2020.353

摘要/Abstract

摘要： 经腹会阴联合切除术(APR)是治疗低位直肠癌的经典术式,它的诞生奠定了直肠癌外科治疗的基础。尽管目前已实现低位、甚至超低位保肛,但对于位置极低(距肛门<3 cm)、浸润括约肌和/或肛提肌等病例,APR仍是推荐术式。最经典的Miles APR因为创伤大,致死率高,逐渐淡出舞台,相继衍生出了传统APR、全直肠系膜切除术(TME)APR、经肛提肌外腹会阴联合切除术(ELAPE)/改良ELAPE等术式。微创技术的应用进步减小了APR的创伤,并能降低神经源性功能障碍的发生率。

关键词: 经腹会阴联合切除术, Miles, 全直肠系膜切除术, 经肛提肌外腹会阴联合切除术, 微创手术

Abstract: Abdominoperineal resection(APR)is a classic surgical procedure for low rectal cancer. Its birth has laid the foundation for surgical treatment of rectal cancer. APR is still recommended in cases of extremely low location(<3 cm from the anus), invading sphincter and/or levator ani muscle, although low or even ultra-low rectal anterior resection has been achieved. The classic Miles APR has gradually faded away for it is traumatic and dangerous. Subsequently, other procedures have emerged, such as traditional APR, total mesorectum excision(TME)APR, and extralevator abdominoperineal excision(ELAPE)/modified ELAPE. Advances in minimally invasive surgery have made APR less traumatic and reduced the incidence of neurogenic dysfunction.

Key words: Abdominoperineal resection, Miles, Total mesorectal excision, Extralevator abdominoperineal excision, Minimally invasive surgery

中图分类号:

R735.3

王刚,江志伟,潘华峰. 经腹会阴联合切除术的回顾与发展[J]. 山东大学学报 (医学版), 2020, 58(5): 6-10.

WANG Gang, JIANG Zhiwei,PAN Huafeng. Review and development of abdominoperineal resection[J]. Journal of Shandong University (Health Sciences), 2020, 58(5): 6-10.

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