低位直肠癌改良Bacon手术操作要点及并发症的预防和处理

Prevention and management of complications in modified Bacon operation for low rectal cancer

近年来我国直肠癌发病率呈逐年上升趋势,且低位直肠癌占比较高,有保肛需求的患者也越来越多。随着腹腔镜手术技术的发展以及对盆底解剖结构认识的深入,低位直肠癌保肛术式也随之发展。在众多保肛术式中,改良Bacon手术相比于其他保肛术式,具有创伤小、无腹部预防性造口、不发生吻合口漏以及能够完整保留肛门结构等诸多优点,逐渐受到结直肠外科同仁的青睐。为了获得理想的治疗效果,在使用该术式时需要掌握其手术关键技术,同时还需要注意其并发症的预防和处理。本文对改良Bacon术式的发展过程、手术要点及相关并发症的预防和处理进行阐述。

Incidence of rectal cancer has been increasing in recent years in China.As the proportion of patients with low rec⁃tal cancer is relatively high,the need for sphincter-preserving surgery increases.Sphincter-preserving surgery emerges with the advances of laparoscopic surgical techniques and further understanding of the pelvic floor anatomy.Compared with other sphinc⁃ter-preserving surgeries,the modified Bacon procedure has several advantages such as less invasiveness,no need for prophylactic stoma,no risk of anastomotic leakage,and complete preservation of the anus.This procedure has gained increasing popularity among colorectal surgeons.To achieve satisfactory treatment outcomes,surgeons must master several key techniques and be aware of the prevention and management of possible complications.In this review,we discuss the development of modified Bacon proce⁃dure,its key surgical techniques,and the prevention and management of complications.