低位直肠癌适形保肛手术操作标准(2023版)

Standardized surgical procedure of conformal sphincter-preservation operation for low rectal cancer(2023 edition)

适形保肛手术(CSPO)是针对低位直肠癌的极限保肛术式,准确的术前诊断评估、合理的手术方式选择和操作、规范的围手术期管理和康复锻炼,是保证CSPO肿瘤根治性和功能保留的关键。然而,关于CSPO的实施尚缺乏相应的临床实践指导意见。在中华医学会外科学分会结直肠外科学组、中国医师协会结直肠肿瘤专业委员会和中国医师协会肛肠医师分会的牵头组织下,集合国内相关领域的专家,通过借鉴国内外最新指南和文献,并结合国内实际情况,讨论制定了本操作标准,从CSPO的定义、分类、相关局部解剖、操作技术、术后并发症和围手术期护理等方面进行阐述,以期促进我国低位直肠癌CSPO的规范化开展。

Conformal sphincter-preservation operation(CSPO)is considered the effective surgical technique for preserving the sphincter in cases of low rectal cancer.Accurate preoperative diagnosis and staging,reasonable selection of surgical approaches and technique,standardized perioperative management,and postoperative rehabilitation are the keys to ensuring the oncological clearance and functional preservation of CSPO.However,there is currently a lack of standardized surgical procedure for implementing CSPO in China.Therefore,the Colorectal Surgery Group of Surgery Branch of the Chinese Medical Association,along with the Colorectal Cancer Committee of the Chinese Medical Doctor Association and the Anorectal Branch of Chinese Medical Doctor Association,gathered experts in colorectal surgery to discuss and establish this standardized surgical procedure of CSPO.This standard,based on the latest evidence from literature,expert experiences,and China national condition,focuses on the definition,classification,pelvic anatomy,surgical techniques,postoperative complications,and perioperative care of CSPO.It aims to guide the standardized clinical practice of CSPO in China.