Rajput Ashwani, Bullard Dunn Kelli
Roswell Park Cancer Institute and The University at Buffalo, State University of New York, Buffalo, NY 14263, USA.
Semin Oncol. 2007 Jun;34(3):241-9. doi: 10.1053/j.seminoncol.2007.03.005.
Rectal cancer affects more than 40,000 people in the United States annually. Despite recent advances in radiation and chemotherapy, surgical resection remains an integral part of curative therapy for this disease. Although rectal cancer is thought to be biologically similar to colon cancer, the anatomic complexity of the pelvis makes therapy for this disease considerably more complicated. Local recurrence is also a greater concern in rectal cancer than in colon cancer. The choice of surgical therapy depends on the location of the tumor, depth of rectal wall invasion, and clinical stage. Surgical options include local excision (transanal excision and transanal endoscopic microsurgery) and radical resection (low anterior resection, extended low anterior resection with coloanal anastomosis, abdominoperineal resection [APR], and pelvic exenteration). Technical advances such as transanal endoscopic microsurgery and laparoscopy also are changing the surgical approach to rectal tumors. Finally, chemotherapy and radiation are now frequently recommended in conjunction with surgical therapy. This article reviews the current surgical approach to treating patients with rectal cancer.
在美国，每年有超过4万人罹患直肠癌。尽管近期放疗和化疗取得了进展，但手术切除仍是该病治愈性治疗不可或缺的一部分。虽然直肠癌在生物学上被认为与结肠癌相似，但盆腔的解剖复杂性使得针对这种疾病的治疗要复杂得多。与结肠癌相比，局部复发在直肠癌中也是一个更令人担忧的问题。手术治疗的选择取决于肿瘤的位置、直肠壁浸润深度以及临床分期。手术方式包括局部切除（经肛门切除和经肛门内镜显微手术）和根治性切除（低位前切除术、扩大低位前切除术加结肠肛管吻合术、腹会阴联合切除术[APR]以及盆腔脏器清除术）。诸如经肛门内镜显微手术和腹腔镜检查等技术进步也正在改变直肠肿瘤的手术方式。最后，目前经常建议化疗和放疗与手术治疗联合使用。本文综述了目前治疗直肠癌患者的手术方法。
