Gilshtein H, Khoury W
Department of General Surgery Rambam Health Care Campus, Haifa, Israel -
Minerva Chir. 2015 Apr;70(2):141-5. Epub 2015 Feb 18.
Squamous cell carcinoma (SCC) is the most common malignancy of the anal canal and anal region. The prevalence of transformation to SCC is much higher in patients with a concomitant human immundefficiency virus (HIV) infection. Historically, treatment of anal SCC consisted of surgical resection with wide local excision for small sized tumors and abdominoperineal resection (APR) for larger and locally invasive cancer. The introduction of chemoradiation by Nigro et al. revolutionized the treatment of SCC. It has improved local recurrence rates as well as survival and need for colostomy. Nowadays, primary surgical treatment is indicated for anal margin tumors that are smaller than 2 cm, and are not poorly differentiated. However, extensive surgery is reserved for those with persistent, progressing and recurrent disease after treatment with the Nigro protocol. Surgical approach for anal canal and margin cancer is to be discussed in this review.
鳞状细胞癌（SCC）是肛管和肛门区域最常见的恶性肿瘤。在合并人类免疫缺陷病毒（HIV）感染的患者中，转化为SCC的发生率要高得多。从历史上看，肛管SCC的治疗包括对小肿瘤进行广泛局部切除的手术切除以及对较大的局部浸润性癌进行腹会阴联合切除术（APR）。Nigro等人引入的放化疗彻底改变了SCC的治疗方式。它提高了局部复发率、生存率以及避免了结肠造口术的需求。如今，对于小于2cm且分化良好的肛门边缘肿瘤，可采用一期手术治疗。然而，对于经Nigro方案治疗后仍有持续性、进展性和复发性疾病的患者，则需进行广泛手术。本综述将讨论肛管和边缘癌的手术方法。
