Colorectal Research, Pelican Cancer Foundation, Basingstoke, Hampshire, UK.
Lancet Oncol. 2009 Dec;10(12):1207-11. doi: 10.1016/S1470-2045(09)70084-1.
Cancer of the low rectum provides a challenge for both preoperative staging and optimum operative management. Current outcomes for patients with low rectal cancer are poor, particularly for those treated by abdominoperineal excision. It has been suggested that this poor outcome is due to an inherent oncological inferiority of the traditional abdominoperineal excision procedure, which might be explained by the unique anatomical features of the low rectum and the lack of clearly defined anatomical excision planes. In this Personal View, we discuss the anatomical and surgical planes available for the management of low rectal cancer, and describe the two-plane approach to low rectal cancer using the mesorectal plane and the extralevator plane.
低位直肠癌的术前分期和最佳手术治疗都极具挑战性。目前低位直肠癌患者的预后较差，尤其是接受腹会阴联合切除术的患者。有人认为，这种不良结果是由于传统的腹会阴切除术在肿瘤学上的固有劣势所致，这可能与低位直肠的独特解剖特征以及缺乏明确界定的解剖切除平面有关。在这篇个人观点中，我们讨论了用于治疗低位直肠癌的解剖和手术平面，并描述了使用直肠系膜平面和外括约肌平面的低位直肠癌双平面方法。
