腹会阴联合切除术：如何进行以及效果如何？
Abdominoperineal resection: how is it done and what are the results?
作者信息
Perry W Brian, Connaughton J Christopher
机构信息
Department of Surgery, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Texas 78236-5300, USA.
出版信息
Clin Colon Rectal Surg. 2007 Aug;20(3):213-20. doi: 10.1055/s-2007-984865.
Abstract
Abdominoperineal resection (APR) for many years was the treatment of choice for most patients with rectal cancer. Recent advances in surgical technique and other treatment modalities have led to a marked increase in the rate of sphincter-sparing operations, with a concomitant decrease in APR. However, it is still necessary in selected patients, especially those with very distal tumors or poor sphincter function. This review will cover the history of APR, current operative strategy and complications, oncologic and quality of life results, as well as potential future advances.
摘要
多年来，腹会阴联合切除术（APR）一直是大多数直肠癌患者的首选治疗方法。手术技术和其他治疗方式的最新进展导致保留括约肌手术的比例显著增加，同时APR的比例相应下降。然而，对于特定患者，尤其是那些肿瘤位置非常低或括约肌功能差的患者，APR仍然是必要的。本综述将涵盖APR的历史、当前的手术策略及并发症、肿瘤学和生活质量结果，以及未来可能的进展。
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2
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J Am Coll Surg. 2006 Sep;203(3):322-7. doi: 10.1016/j.jamcollsurg.2006.05.302. Epub 2006 Jul 21.
3
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4
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Dis Colon Rectum. 2006 Sep;49(9):1354-61. doi: 10.1007/s10350-006-0643-x.
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Minim Invasive Ther Allied Technol. 2004 Dec;13(5):347-61. doi: 10.1080/13645700410006616.
6
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Dis Colon Rectum. 2006 May;49(5):568-78. doi: 10.1007/s10350-006-0513-6.
7
Contemporary indications for and early outcomes of abdominoperineal resection.
Am Surg. 2005 Oct;71(10):837-40.
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J Clin Oncol. 2005 Dec 20;23(36):9257-64. doi: 10.1200/JCO.2005.02.9231.
10
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