腹腔镜经腹会阴低位直肠癌柱状切除及阔筋膜盆底重建的应用（附16例报告）

Application of laparoscopic cylindrical abdominoperineal resection and pelvic reconstruction with tensor fascia latae：a report of 16 cases

目的总结腹腔镜经腹会阴直肠癌柱状切除术和阔筋膜进行盆底重建的临床应用效果。方法16例低位直肠癌患者，先行腹腔镜经腹会阴直肠癌柱状切除，然后取自体阔筋膜进行盆底修复。结果本组患者术中无肠穿孔，病理示环周切缘阴性，术后会阴部伤口均I期愈合。随访8～31个月，无肿瘤复发及死亡。结论柱状经腹会阴直肠癌切除术可以降低Mile手术环周切缘阳性率和肠穿孔率，阔筋膜修补能够满足盆底重建的要求并节省费用。

Objective To conclude the-clinical effectiveness of laparoscopic cylindrical abdomi- noperineal resection（ APR） and pelvic reconstruction with tensor fascia latae. Methods A total of 16 pa- tients with low rectal carcinoma underwent the laparoscopic cylindrical APR and pelvic reconstruction with tensor fascia latae. Results There were no bowel perforation, and the circumferential resection margin （CRM） of all specimens were pathologically negative. Perineal wounds were healed uneventfully. During the 8 - 31 months follow-up, no metastasis or death occurred. Conclusion Clindrical APR reduces the incidence of positive CRM and rectum perfortion. Repair of tensor fascia latae can meet the request of pelvic reconstruction and save the cost.