Low rectal cancer： Sphincter preserving techniques-selectionof patients, techniques and outcomes

• 来源期刊: 世界胃肠肿瘤学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Low rectal cancer SPHINCTER preservingsurgery Intersphincteric RESECTION ANTERIOR PerinealPlanE for Ultra-low ANTERIOR RESECTION of the Rectum Total mesorectal EXCISION TRANSANAL Minimally InvasiveSurgery TRANSANAL Total Mesorectal EXCISION Quality oflife Oncological OUTCOME Functional OUTCOME
• 年，卷（期）: 2015,（7）
• 页码范围: 55-70
• 页数: 16页
• 分类号: R

摘要

Low rectal cancer is traditionally treated by abdominoperinealresection. In recent years, several newtechniques for the treatment of very low rectal cancerpatients aiming to preserve the gastrointestinal continuityand to improve both the oncological as well asthe functional outcomes, have been emerged. Literaturesuggest that when the intersphincteric resection isapplied in T1-3 tumors located within 30-35 mm fromthe anal verge, is technically feasible, safe, with equaloncological outcomes compared to conventional surgeryand acceptable quality of life. The Anterior PerinealPlanE for Ultra-low Anterior Resection technique,is not disrupting the sphincters, but carries a highcomplication rate, while the reports on the oncologicaland functional outcomes are limited. TransanalEndoscopic MicroSurgery （TEM） and TransAnal MinimallyInvasive Surgery （TAMIS） should represent thetreatment of choice for T1 rectal tumors, with specificcriteria according to the NCCN guidelines and favorablepathologic features. Alternatively to the standardconventional surgery, neoadjuvant chemo-radiotherapyfollowed by TEM or TAMIS seems promising for tumorsof a local stage T1sm2-3 or T2. Transanal TotalMesorectal Excision should be performed only whena board approved protocol is available by colorectalsurgeons with extensiveexperience in minimally invasiveand transanal endoscopic surgery.