Marks John H, Frenkel Joseph L, D'Andrea Anthony P, Greenleaf Chistopher E
Lankenau Hospital Colorectal Center, 100 East Lancaster Avenue, Medical Office Building West, Suite 330, Wynnewood, PA 19096, USA.
Surg Oncol Clin N Am. 2011 Jul;20(3):501-20, viii-ix. doi: 10.1016/j.soc.2011.01.008.
Rectal cancer management benefits from a multidisciplinary approach involving medical and radiation oncology as well as surgery. Presented are the current dominant issues in rectal cancer management with an emphasis on our treatment algorithm at the Lankenau Medical Center. By basing surgical decisions on the downstaged rectal cancer we explore how sphincter preservation can be extended even for cancers of the distal 3 cm of the rectum. TATA and TEM techniques can be used to effectively treat cancer from an oncologic standpoint while maintaining a high quality of life through sphincter preservation and avoidance of a permanent colostomy. We review the results of our efforts, including the use of advanced laparoscopy in the surgical management of low rectal cancers.
直肠癌的治疗受益于多学科方法，涉及医学肿瘤学、放射肿瘤学以及外科手术。本文介绍了直肠癌治疗中的当前主要问题，并重点阐述了兰肯瑙医疗中心的治疗方案。通过基于降期直肠癌做出手术决策，我们探讨了如何扩大保肛范围，即使对于直肠远端3厘米处的癌症也适用。经肛门全层切除和经肛门内镜显微手术技术可从肿瘤学角度有效治疗癌症，同时通过保留括约肌和避免永久性结肠造口来维持较高的生活质量。我们回顾了相关成果，包括在低位直肠癌手术治疗中使用先进腹腔镜技术的情况。
