经会阴微创腹会阴联合切除术的临床实践

Clinical practice of transperineal minimally invasive abdominoperineal excision

腹会阴联合切除术(APE)仍然是治疗低位直肠癌的标准手术方式。经肛提肌外APE可降低直肠癌环周切缘阳性率和肿瘤穿孔率,但术后并发症发生率较高。随着微创外科技术的不断发展,有研究者提出经会阴微创腹会阴联合切除术(Tpm-APE)。与传统APE比较,Tpm-APE具有潜在技术优势,然而目前缺乏大样本、多中心临床研究证据支持。笔者分享参与一项国际多中心临床研究的设计与结果,探讨目前Tpm-APE治疗低位直肠癌的临床实践。

The abdominoperineal excision(APE)is still one of the standard operations for low rectal cancer.The exralevator APE can reduce the positive rate of circumferential margin and perforation rate of rectal cancer,but the incidence of postoperative complications is relatively high.With the continuous development of minimally invasive surgery,the transperineal minimally invasive Abdominoperineal excision(Tpm-APE)is proposed.Compared with traditional APE,the Tpm-APE has potential technical advantages,but there is a lack of large sample and l research evidence.The authors share the design and results of an international multicenter clinical study to investigate the clinical practice of Tpm-APE in the treatment of low rectal cancer.