腹腔镜技术在中低位直肠癌保肛手术中的应用价值与评价

Assesment of laparoscopic surgery for mid-low rectal cancer with sphincter preservation

腹腔镜中低位直肠癌手术的应用和可行性得到了大量临床研究的证实,其在中低位直肠癌保肛手术的优势日趋明显。腹腔镜下可以严格遵守肿瘤根治原则和保肛要求,同时保证了保肛手术的安全性。腹腔镜的放大作用使得在肛门括约肌保留和神经保护等方面可能较开腹更有优势,并尽可能保留病人的排便控制功能以及膀胱功能和性功能。最新的临床研究结果肯定了腹腔镜在中低位直肠癌保肛手术中的应用价值,显示了乐观的前景,但其临床应用仍需多中心前瞻性随机对照研究数据的支持。

The application and feasibility of laparoscopic procedure for mid-low rectal cancer were confirmed by increasing clinical studies.The advantages of sphincter preservation for laparoscopic rectal cancer surgery were shown in a growing body of literatures.Laparoscopic surgery for mid-low rectal cancer could strictly adhere to the oncological principle and sphincter-preservating requirement to guarantee the oncologic safty.Laparoscopic multiplication might be superior to the open surgery in terms of anal sphincter saving and nerves protecting,and could retain Defecation control ability,bladder and sexual function.In conclusion,the data from the recent trials have shown promising clinical benefits of short-term advantages as well as long-term oncologic equivalence for laparoscopic surgery for mid-low rectal cancer in sphincter preservation resection.However,adequately powered,multiple center trials are justified and necessary to assess the role of laparoscopy in mid-low rectal cancer sphincter-preservating surgery.