Abstract:

Emphasize on the postoperative anal function of middle and low rectal cancer patients        YE Ying-jiang，LIU Fan. Department of Gastroenterological Surgery，Peking University People’s Hospital，Beijing 100044，China
Corresponding author：YE Ying-jiang，E-mail:yeyingjiang@pkuph.edu.cn
Abstract    Organ function preservation emphasizes the application of various therapeutic techniques to avoid or reduce the influence of tumor treatment process on the normal function of cancer organs and adjacent organs under the premise of ensuring the best prognosis of oncology. Modern surgical treatment of middle and low rectal cancer does require anal organ function preservation, but the current rectal cancer guidelines lack guidance on how to protect organ function. In the author's opinion，modern colorectal surgeons should recognize that anal function is an important factor affecting the quality of life after rectal cancer surgery. Functional considerations should be raised to the same level as technique as to whether the patient should preserve the anus. Correct evaluation of postoperative defecation function of patients is the basis of selecting anal preservation indications. Preoperative evaluation of risk factors for anal dysfunction are helpful to predict postoperative functional status. The rational use of multidisciplinary strategies is recommended to reduce surgical trauma and improve anastomosis techniques to achieve functional preservation in middle and low rectal cancer.

Key words: rectal cancer, sphincter preserving surgery, organ function preserving, anorectal function

摘要：

器官功能保护强调了在保证最佳肿瘤学预后的前提下，运用多种治疗技术和手段，避免或减少肿瘤治疗过程对患癌器官及其毗邻器官正常功能的影响。现代中低位直肠癌的外科治疗目标提出了较高的肛门直肠器官功能保护要求，但是现行的肿瘤治疗指南中缺少如何进行器官功能保护的指导。结直肠外科医生应认识到肛门功能是影响直肠癌病人术后生活质量的重要因素，对于病人是否应该保肛，对于功能方面的考量须提高到和技术相同的高度。正确地评估病人术后排便功能情况是选择保肛适应证的基础，术前评价病人是否存在肛门功能不佳的危险因素能够很好地预判术后功能状态；推荐合理地使用多学科策略以减少手术创伤和改进吻合方式等途径来实现中低位直肠癌肛门功能保护。

关键词: 直肠癌, 保肛手术, 器官功能保护, 肛门直肠功能