肛提肌外腹会阴联合切除术治疗低位直肠癌

Extra-levator Abdominoperineal Exicision in the Treatment of Low Rectal Carcinoma

为研究肛提肌外腹会阴联合切除术（ELAPE）治疗低位直肠癌的方法及效果，回顾性分析18例采用ELAPE治疗的低位直肠癌患者的临床资料。结果显示，平均手术时间为（2804-20）min，无术中输血病例，均为根治性手术切除，无手术死亡病例。术后会阴部切口感染1例，骶尾部疼痛1例，无排尿功能障碍。结果表明，ELAPE直视下解剖会阴部组织，可精确切除导致术后复发的关键性组织结构，可行必要的侧方淋巴结清扫，可降低局部复发率，提高患者生存率，是一种有效可行的手术方式。、

In order to investigate the method and its effect of extra-levator abdominoperined exicision （ELAPE） for lower rectal carcinoma, authors retrospectively analyzed the data of the 18 patients of low rectal carcinoma who had received ELAPE.As results,the average time for operation was 280±20 min;all were resected through radical operation,no intraoperative infusion blood,and no operative death case ; after surgery,1 case suffered from perineum wound infection, 1 cases from sacrococcygeal pain,no dysuria was found.Results show that using ELAPE under direct vision to dissect perineum can accurately resect the key tissue inducing postoperative recurrence, and perform neccesary laternal lymphadenectomy （clearance）, reduce local recurrence rate, thus lift the survival rate of patients,in a word,it is an effective and reliable procedure.