Choi Hong-Jo
Department of Surgery, Dong-A University College of Medicine, Busan, Korea.
Korean J Gastroenterol. 2006 Apr;47(4):260-7.
Although optimal treatment of tumors at mid and distal rectum continues to be a matter of great debate to oncologic surgeons, a surgical goal of sphincter preservation should be considered in all patients with an intact sphincter. There are growing evidences and indications that sphincter-preserving procedure might be a valid alternative to conventional modality in tumors of the mid or lower rectum. Traditionally, an abdominoperineal resection with permanent colostomy would be the sole surgical option. Recently, a variety of sphincter-preserving procedures are performed in majority of distal rectal cancers with acceptable oncologic and optimal functional results. Several recent advances may further influence future treatment strategies and many issues are, at present, under evaluation. Here, some of the most relevant topics regarding current methods of sphincter-preserving procedures with their oncologic and functional results are discussed to establish the guideline of surgical treatment in rectal cancer.
尽管中低位直肠癌的最佳治疗方案仍是肿瘤外科医生激烈争论的话题,但对于所有括约肌功能完好的患者,都应考虑保肛手术这一目标。越来越多的证据和迹象表明,在中低位直肠癌的治疗中,保肛手术可能是传统术式的有效替代方案。传统上,腹会阴联合切除术加永久性结肠造口术是唯一的手术选择。近来,大多数低位直肠癌患者都接受了各种保肛手术,取得了可接受的肿瘤学效果和最佳功能结果。最近的一些进展可能会进一步影响未来的治疗策略,目前许多问题仍在评估中。在此,讨论一些与当前保肛手术方法及其肿瘤学和功能结果最相关的话题,以确立直肠癌手术治疗的指南。