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Surg Clin North Am. 2020 Jun;100(3):615-628. doi: 10.1016/j.suc.2020.02.014. Epub 2020 Apr 15.
Rectal cancer is often presented with a dizzying array of treatment recommendations. This article clarifies and simplifies this common clinical problem from the surgical perspective. Treatment of rectal cancer requires an understanding of presenting stage (early or advanced) and location (high or low) to provide oncologic sound treatment decisions. Surgical treatment requires a minimum of 1 cm distal margin, careful clearance of the mesorectum and radial margin using total mesorectal excision technique, and 12 or more regional lymph nodes harvested and analyzed. Appropriate and effective multimodality treatments exist and must be used based on sound guidelines as outlined.
直肠癌的治疗建议纷繁复杂。本文从外科角度阐明并简化了这一常见临床问题。治疗直肠癌需要了解其分期(早期或晚期)和部位(高位或低位),以便做出合理的肿瘤治疗决策。外科治疗需要远端切缘至少 1cm,采用全直肠系膜切除术技术仔细清除直肠系膜和直肠周围间隙,并且需要采集和分析 12 个或更多的区域淋巴结。存在合适且有效的多模式治疗方法,必须根据既定指南合理使用。