低位直肠癌经肛提肌外腹会阴联合切除术的研究进展

发布时间：2018-04-28 23:37

本文选题：直肠癌 + 肛提肌外腹会阴联合切除术　；参考：《中华肿瘤防治杂志》2017年09期

【摘要】：目的肛提肌外腹会阴联合切除术(exralevator abdominoperineal excision,ELAPE)的提出旨在改善低位直肠癌的手术安全性和肿瘤预后,但其应用仍存在争议。本研究总结ELAPE治疗低位直肠癌的最新研究进展。方法应用PubMed及CNKI期刊全文数据库检索系统,以"肛提肌外、腹会阴联合切除术和低位直肠癌"为关键词,检索2006-01-2015-12的相关文献。纳入标准:(1)ELAPE的疗效分析;(2)ELAPE术后并发症的处理;(3)ELAPE的适用范围;(4)ELAPE体位的选择。排除标准:(1)综述和会议汇编等相关文献;(2)实验设计不严谨。根据纳入和排除标准,符合分析53篇,其中英文文献45篇,中文文献8篇。结果手术是低位直肠癌的首选治疗方案,ELAPE作为治疗低位直肠癌新的术式,目前其手术体位,术后盆底重建,手术疗效及适用范围等方面存在诸多争议,仍需要进一步探讨,尤其是手术疗效及患者术后生活质量亟需进一步的前瞻性研究来验证。结论 ELAPE尚不能取代传统腹会阴联合切除术(abdominoperineal excision,APE)而成为治疗低位直肠癌的标准术式,ELAPE术式可能还需要进一步优化和改进。
[Abstract]:Objective to improve the safety and prognosis of low rectal cancer by exralevator abdominoperineal excisioning combined excision of levator ani and ventral perineum, but its application is still controversial. This study summarizes the latest advances in the treatment of low rectal cancer with ELAPE. Methods by using the PubMed and CNKI full text database retrieval system, we searched the relevant literature of 2006-01-2015-12 with the key words of "Extra-levator muscle, combined abdominal perineum resection and low rectal cancer". Treatment of postoperative complications of ELAPE and the selection of position of ELAPE. Exclusion Standard: 1) Review and Conference Compendium, etc.) the experimental design is not rigorous. According to the criteria of inclusion and exclusion, there were 53 articles in accordance with the analysis, including 45 articles in Chinese and 45 articles in Chinese, and 8 articles in Chinese. Results Operation is the first choice for the treatment of low rectal cancer. At present, there are many controversies in the position of operation, the reconstruction of pelvic floor after operation, the curative effect and the scope of application, and so on, which still need to be further discussed. In particular, the efficacy of surgery and postoperative quality of life need further prospective research to verify. Conclusion ELAPE can not replace the traditional abdominal perineum combined excision (abdominoperineal excision) and become the standard procedure for the treatment of low rectal cancer.
【作者单位】：威海市立医院胃肠外科;
【基金】：威海市科技发展计划(2015FZA01005)
【分类号】：R735.37

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