University Hospitals Leicester, Leicester, UK.
Tech Coloproctol. 2012 Feb;16(1):73-5. doi: 10.1007/s10151-011-0797-y. Epub 2011 Dec 15.
We report a combined laparoscopic and open technique for extralevator abdominal perineal excision of the rectum. The key steps are a laparoscopic rectal dissection limited distally by the coccyx. The open, prone, perineal dissection affords excellent views and allows a cylindrical specimen to be obtained. The resulting perineal defect is closed by a biological mesh. Extralevator abdominal perineal excision of the rectum offers a superior oncological specimen with reduced circumferential resection margin involvement compared to traditional techniques. Combined with a laparoscopic approach, this also has the potential to improve postoperative recovery and reduce morbidity.
我们报告了一种联合腹腔镜和开放性技术用于经腹会阴联合切除直肠（extralevator abdominal perineal excision of the rectum，APER）。关键步骤是腹腔镜下的直肠分离，仅在尾骨处保留远端。开放性、俯卧位、会阴分离提供了极好的视野，并允许获得圆柱形标本。生物网片用于关闭会阴部的缺损。与传统技术相比，经腹会阴联合切除直肠（extralevator abdominal perineal excision of the rectum，APER）能够提供更好的肿瘤学标本，并且减少了环周切缘的受累。结合腹腔镜方法，这也有可能改善术后恢复并降低发病率。
