经肛门局部切除手术在直肠癌治疗中的作用

Effect of transanal excision in the treatment of rectal cancer

直肠癌的外科手术方法包括经腹根治术及局部切除术。全直肠系膜切除术（TME）是直肠癌外科治疗的金标准．随着功能外科时代的到来．越来越多的证据表明．在严格选择适应证的前提下．早期直肠癌患者行局部切除手术可以获得和传统经腹根治术相同的生存率。但总体而言．局部切除术后的局部复发率要高于TME．因此需要术前做到全面、精确的分期和评估．从而严格掌握局部切除的手术适应证。

The surgical approach for rectal cancer includes trans-abdominal and transanal excision. Total mesorectal excision （TME） is the golden standard for surgical treatment. In the functional surgery era, more and more evidence shows that under strict indications, traditional abdominal radical surgery and transanal excision can achieve similar survival in patients with early stage cancer. However, the local recurrence rate of local resection was significantly higher compared to TME, suggesting strict patients selection for transanal excision. Preoperative accurate evaluation is critical in clinical practice.