Takahashi T, Ohta H, Azekura K, Ueno M
Surgical Department of Cancer Institute Hospital, Tokyo.
Acta Chir Iugosl. 2000;47(4 Suppl 1):7-11.
The definition of coloanal anastomosis should be based on anatomy of the anal canal. The anal canal is terminal portion of the digestive tract and comprises muscle tube of approximately 3 cm long with a lumen coated with several types of mucosa or epithelium. Muscle tube of the anal canal consists of two layers, inner sphincter muscle and external sphincter muscle. The former is a continuation of rectal muscle layer and the latter extends to the levator ani muscle. Colo-anal anastomosis (CACA): whole of the rectum is excised with a separation line placed just above the anal canal. An anastomosis is made between colonic cut end and upper limit of the anal canal. Colo-anus anastomosis in a narrow sense (CAA): rectum is excised with a bit of upper part of the anal canal. Then an anastomosis is made inside the anal canal.
结肛管吻合术的定义应基于肛管的解剖结构。肛管是消化道的终末部分，由长约3厘米的肌性管道组成，其管腔覆盖有几种类型的黏膜或上皮。肛管的肌性管道由两层组成，即内括约肌和外括约肌。前者是直肠肌层的延续，后者延伸至肛提肌。结肛管吻合术（CACA）：将整个直肠在肛管上方的位置进行分离切除，然后在结肠断端与肛管上限之间进行吻合。狭义的结肠肛管吻合术（CAA）：切除直肠及肛管上部的一小部分，然后在肛管内进行吻合。
