低位直肠癌诊治新策略

New strategy for diagnosis and treatment of low rectal cancer

低位直肠癌解剖结构特殊使其诊治成为一大难点。近年来,随着一些新理念、新技术的出现,低位直肠癌诊治水平明显提高,主要表现为术前诊断与分期更加精确、全直肠系膜切除(total mesorectal excision,TME)理念标准化、腹腔镜及经自然腔道微创理念得到认可,全程新辅助治疗观念的融入,使手术切除率、根治切除率及术后生存质量不断提高。直肠癌外科治疗已从追求"肿瘤根治"变为"肿瘤根治+改善生活"。在保证根治的前提下,最大限度地提高患者术后生活质量成为目前低位直肠癌外科治疗的热点。

Because of the special anatomy of low rectal cancer,the diagnosis and treatment has become a major difficult problem.In recent years,with the emergence of new concepts and new techniques,the level of diagnosis and treatment of low rectal cancer has been significantly improved,mainly in the preoperative diagnosis and staging more accurate,the total mesorectal excision（TME）concept standardized,laparoscopy and the concept of natural cavity minimally invasive,the whole course of neoadjuvant treatment,so that the surgical resection rate,radical resection rate and postoperative quality of life are improved.Rectal cancer surgery has changed from ＂radical cancer＂ to ＂tumor eradication improvement of life＂.Under the premise of ensuring radical cure,maximizing the quality of life of postoperative patients has become a hot spot in the surgical treatment of low rectal cancer.This article reviews the new strategies for the diagnosis and treatment of low rectal cancer.