腹腔镜低位直肠癌保肛手术的术式发展及相关热点问题

doi:10.16139/j.1007-9610.2025.04.11

摘要/Abstract

摘要：

直肠癌是国内、外常见的恶性肿瘤。尽管目前适用低位直肠癌的保肛术式众多，各有其适应证及优劣，但缺乏一种能在保留肛门功能、减少并发症发生、降低局部复发率、提高生活质量等方面均达到完美的术式。本文就腹腔镜低位直肠癌保肛术式的发展历程展开回顾，并针对目前手术存在诸如吻合口漏的预防和处理、充分下切缘的获取、功能学预后等痛点及相关对策进行阐述。

关键词: 低位直肠癌, 腹腔镜, 保肛手术, 吻合口漏

Abstract:

Rectal cancer is a prevalent malignant tumor both in China and worldwide. Despite the availability of numerous sphincter-preserving procedures for low rectal cancer, each with specific indications, advantages, and limitations, no single procedure achieves optimal outcomes in all key domains: anal function preservation, surgical complication reduction, local recurrence rate minimization, and patient quality of life improvement. This article reviewed the evolutionary trajectory of laparoscopic sphincter-preserving surgery for low rectal cancer, while addressing current surgical challenges including prevention and management of anastomotic leakage, strategies for ensuring adequate distal resection margins, and functional outcomes prognosis. Corresponding countermeasures for these critical issues were systematically discussed.

Key words: Low rectal cancer, Laparoscopy, Sphincter-preserving surgery, Anastomotic leakage

中图分类号:

R735.37

支亦豪, 赵轩, 郑民华. 腹腔镜低位直肠癌保肛手术的术式发展及相关热点问题[J]. 外科理论与实践, 2025, 30(04): 358-363.

ZHI Yihao, ZHAO Xuan, ZHENG Minhua. Evolution and hot topics of laparoscopic sphincter-preserving surgery for low rectal cancer[J]. Journal of Surgery Concepts & Practice, 2025, 30(04): 358-363.

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