Lau Yee Chen, Brown Kilian G M, Lee Peter
Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia.
Surgical Outcomes Research Centre (SOuRCe), Sydney, Australia.
J Gastrointest Oncol. 2019 Dec;10(6):1207-1214. doi: 10.21037/jgo.2019.01.21.
There have been significant advances in the surgical management of locally advanced and recurrent rectal cancer in recent decades. Patient with advanced pelvic tumours involving adjacent organs and neurovascular structures, beyond the traditional mesorectal planes, who would have traditionally been considered irresectable at many centres, now undergo surgery routinely at specialised units. While high rates of morbidity and mortality were reported by the pioneers of pelvic exenteration (PE) in early literature, this is now considered historical data. In 2019, patients who undergo PE for advanced or recurrent rectal cancer can expect reasonable rates of long-term survival (up to 60% at 5 years) and acceptable morbidity and quality of life. This article describes the surgical techniques that have been developed for radical multivisceral pelvic resections and reviews contemporary outcomes.
近几十年来，局部晚期和复发性直肠癌的外科治疗取得了重大进展。患有累及相邻器官和神经血管结构的晚期盆腔肿瘤的患者，超出了传统的直肠系膜平面，在许多中心传统上会被认为无法切除，现在在专门的科室可以常规接受手术。虽然早期文献中盆腔脏器清除术（PE）的先驱者报告了较高的发病率和死亡率，但现在这被视为历史数据。2019年，因晚期或复发性直肠癌接受PE的患者有望获得合理的长期生存率（5年高达60%）以及可接受的发病率和生活质量。本文描述了为根治性多脏器盆腔切除术所开发的手术技术，并回顾了当代的治疗结果。
