关键词: 低位直肠癌, 手术方式, 手术质量, 保留肛门

Abstract:

Selection and evaluation of surgical approaches for low rectal cancer        WANG Jian-ping. Department of Colon and Rectum Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease,Guangzhou 510655, China
Abstract    The differences of surgeon's experience and the patients individual often lead to diffent operation effects. Low rectal cancer is common in Chinese rectal cancer patients，and it has various surgical approaches. Dixon is the most satisfactory operation for the radical resection and sphincter preservation. Transanal and transsacrococcygeal local excision are applied to early low rectal cancer. Transanal TME is appropriate for young men with obesity or narrow pelvis. Hartmann is for elderly patients who can not tolerate surgery or have anorexia dysfunction. Parks is suitable for tumors 4 to 6 cm up to the dentate line and can not be performed with Dixon or stapler anastomosis. Bacon is for patients with fistula. Intersphincteric resection is a sphincter-preserving surgery for early rectal cancer that is lower than the above-mentioned tumors. APR and extralevator APE are for patients without sphincter preservation. It is necessary to choose surgical approaches based on patient's condition and surgeon's experience，and assess the quality of surgery. Both radical resection and function preservation are focused in low rectal cancer now. However，it is essential to define the indications for sphincter preservation and choose an appropriate surgical approach.

Key words: low rectal cancer, surgical approaches, surgical quality, sphincter preservation