低位直肠癌根治术盆底腹膜重建策略的研究现状

doi:10.3877/cma.j.issn.1674-0793.2023.04.018

中华普通外科学文献(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 316 -320. doi: 10.3877/cma.j.issn.1674-0793.2023.04.018

综述

低位直肠癌根治术盆底腹膜重建策略的研究现状

杨康, 王得晨, 杨自杰, 归明彬, 杨增强, 屈莲平, 高峰^†(

)

750004　银川，宁夏医科大学；730050　兰州，中国人民解放军联勤保障部队第九四〇医院肛肠科
730050　兰州，中国人民解放军联勤保障部队第九四〇医院肛肠科
730050　兰州，中国人民解放军联勤保障部队第九四〇医院肛肠科；730000　兰州，甘肃中医药大学

收稿日期:2022-09-23 出版日期:2023-08-01
通信作者: 高峰
基金资助:
甘肃省科技计划项目(20YF8FA098)

Current status and strategies of pelvic floor peritoneum reconstruction in radical resection for low rectal cancer

Kang Yang, Dechen Wang, Zijie Yang, Mingbin Gui, Zengqiang Yang, Lianping Qu, Feng Gao^†()

Ningxia Medical University, Yinchuan 750004, China; Department of Anorectal Surgery, the 940th Hospital of Joint Logistics Support Force of the Chinese People’s Liberation Army, Lanzhou 730050, China
Department of Anorectal Surgery, the 940th Hospital of Joint Logistics Support Force of the Chinese People’s Liberation Army, Lanzhou 730050, China
Department of Anorectal Surgery, the 940th Hospital of Joint Logistics Support Force of the Chinese People’s Liberation Army, Lanzhou 730050, China; Gansu University of Chinese Medicine, Lanzhou 730000, China

Received:2022-09-23 Published:2023-08-01
Corresponding author: Feng Gao

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杨康, 王得晨, 杨自杰, 归明彬, 杨增强, 屈莲平, 高峰. 低位直肠癌根治术盆底腹膜重建策略的研究现状[J]. 中华普通外科学文献(电子版), 2023, 17(04): 316-320.

Kang Yang, Dechen Wang, Zijie Yang, Mingbin Gui, Zengqiang Yang, Lianping Qu, Feng Gao. Current status and strategies of pelvic floor peritoneum reconstruction in radical resection for low rectal cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(04): 316-320.

直肠癌手术方式主要包括腹腔镜辅助低位前切除术和腹会阴联合切除术。临床对直肠膜解剖不断深入的认识，增强了手术的安全性，提高了肿瘤的完整切除和患者预后生存，但两种术式不可避免会破坏盆底腹膜的完整性，导致患者术后出现会阴部感染、会阴疝、肠梗阻、放射性肠炎、排尿功能障碍等并发症。大量研究发现并发症的发生可能与盆底腹膜重建具有相关性，但对于术中是否需行盆底腹膜重建仍存在较大争议，尤其腹会阴联合切除术更具争议性。本文旨在阐述直肠癌根治术中盆底腹膜重建策略、方式及并发症的研究进展。

关键词: 直肠肿瘤, 盆底腹膜重建, 重建方式, 并发症

Currently, the treatment of rectal malignancies mainly include laparoscopic-assisted low anterior resection and combined abdominoperineal resection. Although the safety of surgery has been improved with the continuous refinement of rectal membrane anatomy, both procedures inevitably destroy the integrity of the pelvic floor peritoneum, followed by complications such as perineal infection, perineal hernia, intestinal obstruction, radiation enteritis , and urinary dysfunction. A number of studies have found that the occurrence of complications may be correlated with pelvic floor peritoneal reconstruction, but the need for intraoperative pelvic floor peritoneum reconstruction is still controversial, especially for combined abdominoperineal resection. The purpose of this article is to describe the progress of research on pelvic floor peritoneal reconstruction strategies, modalities and complications of radical rectal cancer surgery.

Key words: Rectal neoplasms, Pelvic floor peritoneum reconstruction, Methods of reconstruction, Complications

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