低位直肠癌的腹腔镜手术——内括约肌切除术、Miles手术还是肛提肌外腹会阴联合直肠切除术

Laparoscopic surgery for low rectal cancer, intersphincteric resection, Miles or extralevator abdominoperineal excision

目前，腹腔镜直肠癌手术中的安全性及有效性已被大量循证医学证据所证实，因此，腹腔镜手术已经广泛应用于低位直肠癌的治疗中。直肠癌手术是否能保留肛门，是医生与患者均十分关注的重要问题。保肛手术应在保证肿瘤R0切除的前提下进行。本文就低位直肠癌手术中腹腔镜技术的应用及保肛手术的术式选择进行讨论。

Currently, the safety and efficiency of laparoscopic surgery for rectal cancer have been confirmed by large amount of evidences. Laparoscopic surgery has been commonly applied in the treatment for low rectal cancer. Sphincter preservation is a highly concerning issue for patients and surgeons during rectal cancer surgery. Sphincter-preserving surgery should be based on the R0 resection. The article reviews the application of laparoscopic surgery for low rectal cancer and the choice of operations for sphincter-preserving surgery.