关键词: 低位直肠癌, 保肛手术

Abstract:

Sphincter-preserving surgery for low rectal cancer：Selection and evaluation        XU Jian-min, FENG Qing-yang. Department of General Surgery, Zhongshan Hospital，Fudan University, Shanghai200032,China
Corresponding author：XU Jian-min，E-mail：xujmin@aliyun.com
Abstract    The lymphatic drainage of rectal cancer is the basis of sphincter-preserving surgery. The main difficulty of sphincter-preserving surgery for low rectal cancer locates in balancing the distal resection margin and the length of remaining rectum. Different sphincter-preserving surgical approaches have their own advantages. Rectal cancer anterior resection is the most common surgical approach of sphincter-preserving surgery. But for less than 2cm of remaining rectum after tumor resection，the anterior resection is not appropriate. Compared with traditional approaches，the intersphincteric resection (ISR) and anterior perineal plane for ultra-low anterior resection (APPEAR) can achieve sphincter preservation for lower position of tumors. With the development of surgical instruments，minimally invasive techniques have been gradually applied in sphincter-preserving surgery. The advantages of robotic surgery mainly focus on more convenient operation and better protection of pelvic organs，compared with conventional laparoscopy. Surgical techniques of local excision have also made great progress. But the indications should be rigorously evaluated.

Key words: low rectal cancer, sphincter-preserving surgery