Zhang W, Zhu X M
Department of Colorectal Surgery, Changhai Hospital, The Navy Medical University, Shanghai 200433, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2023 Jun 25;26(6):557-561. doi: 10.3760/cma.j.cn441530-20230603-00191.
ISR is the most widely used anal-preserving operation for ultra-low rectal cancer. It can be divided into total ISR, subtotal ISR and partial ISR according to the resection range of internal sphincter. The advantage of ISR is that it can preserve the sphincter while ensuring the safety of oncology for ultra-low rectal cancer, representing the state of the art. However, it still needs to face the problem that the quality of life will decline due to poor postoperative anal function. The conformal sphincter-preserving operation (CSPO) is a functional anal-preserving surgery improved on the basis of ISR. It is superior to ISR in the postoperative anal function and patients' quality of life. So it can be a new choice for ultra-low rectal cancer.
ISR是用于超低位直肠癌最广泛应用的保肛手术。根据内括约肌的切除范围，它可分为全直肠系膜内括约肌切除术（total ISR）、次全直肠系膜内括约肌切除术（subtotal ISR）和部分直肠系膜内括约肌切除术（partial ISR）。ISR的优点是在确保超低位直肠癌肿瘤学安全性的同时能够保留括约肌，代表了目前的先进水平。然而，它仍需面对术后肛门功能不佳导致生活质量下降的问题。适形保肛手术（CSPO）是在ISR基础上改进的功能性保肛手术。它在术后肛门功能和患者生活质量方面优于ISR。因此，它可以成为超低位直肠癌的一种新选择。
