Hou S, Liu F, Ye Y J
Department of Gastrointestinal Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2021 Apr 25;24(4):372-376. doi: 10.3760/cma.j.cn.441530-20201223-00672.
Straight coloanal anastomosis (SCA), colonic J-pouch anastomosis (CJP), transverse coloplasty pouch anastomosis (TCP), and side-to-end anastomosis (SEA) are the most commonly used procedures of bowel reconstructions in the low anterior resections (LAR) of rectal cancer. Different bowel reconstruction procedures greatly affect postoperative bowel function, urinary function and sexual function. SCA is the most traditional procedure. CJP has been studied extensively and well-developed reconstruction method; however, recent studies have shown that CJP has the highest morbidity of complications, so the clinical application of CJP is limited. SEA is not inferior to CJP and SCA in the short-term and long-term defecation function, urination function, and sexual function, with reliable operational safety, so it is expected to become an alternative to SCA and CJP. The research on TCP is lacking, but there are some related clinical trials currently underway, and the results are worth expecting. The improvement and innovation of bowel reconstructions provide a bright prospect for better functional prognosis in patients with rectal cancer.
直结肠吻合术(SCA)、结肠J形贮袋吻合术(CJP)、横结肠成形贮袋吻合术(TCP)和端侧吻合术(SEA)是直肠癌低位前切除术(LAR)中最常用的肠道重建手术方式。不同的肠道重建手术对术后肠道功能、泌尿功能和性功能有很大影响。SCA是最传统的手术方式。CJP是一种经过广泛研究且发展成熟的重建方法;然而,近期研究表明CJP并发症发生率最高,因此其临床应用受到限制。SEA在短期和长期排便功能、排尿功能及性功能方面不逊色于CJP和SCA,手术安全性可靠,因此有望成为SCA和CJP的替代方案。关于TCP的研究较少,但目前有一些相关临床试验正在进行,结果值得期待。肠道重建的改进与创新为直肠癌患者获得更好的功能预后提供了光明前景。