Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity...Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity and to improve both the oncological as well as the functional outcomes, have been emerged. Literature suggest that when the intersphincteric resection is applied in T1-3 tumors located within 30-35 mm from the anal verge, is technically feasible, safe, with equal oncological outcomes compared to conventional surgery and acceptable quality of life. The Anterior Perineal Plan E for Ultra-low Anterior Resection technique, is not disrupting the sphincters, but carries a high complication rate, while the reports on the oncological and functional outcomes are limited. Transanal Endoscopic Micro Surgery(TEM) and Trans Anal Minimally Invasive Surgery(TAMIS) should represent the treatment of choice for T1 rectal tumors, with specific criteria according to the NCCN guidelines and favorable pathologic features. Alternatively to the standard conventional surgery, neoadjuvant chemo-radiotherapy followed by TEM or TAMIS seems promising for tumors of a local stage T1sm2-3 or T2. Transanal Total Mesorectal Excision should be performed only when a board approved protocol is available by colorectal surgeons with extensive experience in minimally invasive and transanal endoscopic surgery.展开更多
目的总结11例经前会阴超低位直肠切除术(anterior perineal plane for ultra-low anterior resection of the rectum,APPEAR)的手术配合要点。方法对11例APPEAR的手术配合要点进行分析和总结。结果 11例患者均顺利完成手术,手术时间1.5-...目的总结11例经前会阴超低位直肠切除术(anterior perineal plane for ultra-low anterior resection of the rectum,APPEAR)的手术配合要点。方法对11例APPEAR的手术配合要点进行分析和总结。结果 11例患者均顺利完成手术,手术时间1.5-3 h、平均(2.22±0.50)h;住院时间10-49 d,平均(21.25±10.20)d;其中术后并发会阴伤口感染3例(27.30%),经换药后痊愈。结论完善的术前准备、熟练的术中配合和严格的无菌操作是APPEAR成功的关键。展开更多
文摘Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity and to improve both the oncological as well as the functional outcomes, have been emerged. Literature suggest that when the intersphincteric resection is applied in T1-3 tumors located within 30-35 mm from the anal verge, is technically feasible, safe, with equal oncological outcomes compared to conventional surgery and acceptable quality of life. The Anterior Perineal Plan E for Ultra-low Anterior Resection technique, is not disrupting the sphincters, but carries a high complication rate, while the reports on the oncological and functional outcomes are limited. Transanal Endoscopic Micro Surgery(TEM) and Trans Anal Minimally Invasive Surgery(TAMIS) should represent the treatment of choice for T1 rectal tumors, with specific criteria according to the NCCN guidelines and favorable pathologic features. Alternatively to the standard conventional surgery, neoadjuvant chemo-radiotherapy followed by TEM or TAMIS seems promising for tumors of a local stage T1sm2-3 or T2. Transanal Total Mesorectal Excision should be performed only when a board approved protocol is available by colorectal surgeons with extensive experience in minimally invasive and transanal endoscopic surgery.
文摘目的总结11例经前会阴超低位直肠切除术(anterior perineal plane for ultra-low anterior resection of the rectum,APPEAR)的手术配合要点。方法对11例APPEAR的手术配合要点进行分析和总结。结果 11例患者均顺利完成手术,手术时间1.5-3 h、平均(2.22±0.50)h;住院时间10-49 d,平均(21.25±10.20)d;其中术后并发会阴伤口感染3例(27.30%),经换药后痊愈。结论完善的术前准备、熟练的术中配合和严格的无菌操作是APPEAR成功的关键。
