Resection of rectal cancer by sphincter preserving resection of rectal cancer"

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In recent years, some of the distance within the dentate line 2cm of rectal cancer patients with laparoscopic intersphincteric resection (IS

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In recent years, some of the distance within the dentate line 2cm of rectal cancer patients with laparoscopic intersphincteric resection (ISR) to achieve radical resection and abdominal incision anus preserving surgery, a year after surgery, six months and three months were not found in patients with local recurrence of the tumor, can say anus preserving surgery has not limited to the tumor from the anal far, if no tumor invasion of the anal sphincter, regardless of how close the distance of anal rectal cancer radical resection and anal preservation can reach the limit, "zero distance preserving anus", because bowel function is affected by the external anal sphincter control, so long as to retain the integrity of the external anal sphincter to radical resection for rectal cancer and keep the anus bowel function and. We will take effect more excellent laparoscopic operation combined with ISR, not only can the radical resection of the tumor, anus preserving, can also be no abdominal incision, excision specimens directly from the anus out, perfect the minimally invasive surgery of rectal cancer. In the past, such a distance of rectal cancer is basically to do permanent colostomy (commonly known as anal diversion). But if the tumor did not break through the outer membrane, plus the patient strongly urged to retain anus, we can take [intersphincteric resection] - intersphincteric resection (ISR) to complete the super low rectal cancer and rectal surgery, in the dentate line following 1cm rectal sphincter and external sphincter and bottom-up free resection of the tumor, only external anal sphincter, levator muscle of puborectalis and anal part, this still guarantee the removal of the full range of effects and achieve radical preservation of anus. This is the meaning of the operation: first, the rectal cancer anal surgery no longer depends on the tumor from the anal far, but depends on the depth of tumor invasion (rectal surgery no distance limit), if preoperative EUS examination did not penetrate the muscle layer, no matter how close the distance of anal tumor can be radical resection and retention anal. Second, must be clear, ultra low rectal cancer intersphincteric resection of rectal cancer is not equal to the traditional pull operation. [] intersphincteric resection of rectal cancer resection for rectal cancer resection is not only due to the internal anal sphincter, so that tumor resection margin enough, can be said to have been cut to the anal skin, as long as the tumor invasion a rectal muscular layer, no matter how low position, can be successfully removed the tumor and anal preservation. Third, without the aid of double stapling cases, the resection range is bigger, more injury to the anal sphincter is very small, for ultra low rectal cancer surgery than with double stapling effect is better, but also to save nearly million yuan for medical expenses of patients. The use of double stapling nor anus preserving surgery, rectal cancer [intersphincteric resection] you can still do the radical and the anus. Fourth, [colorectal cancer] intersphincteric resection because they have to cut down the anal skin, colon and anal sphincter anastomosis, anastomotic directly exposed, do not have to worry about the peritonitis caused by anastomotic leakage and intra-abdominal infections. Fifth, the abdominal part of the operation to do laparoscopic, colon pull down the anastomosis, abdominal incision, so less trauma, more beautiful, in the future, we will vigorously promote the abdominal incision surgery. To sum up, this operation has the domestic advanced level. So, what is the rectum cancer through the sphincter resection? We briefly introduced as follows: after anal surgery intersphincteric resection for ultra-low rectal cancer, with good radical, and can better preserve the anal function. For the earlier or preoperative radiotherapy and chemotherapy sensitive ultra low rectal cancer, rectal stromal tumor, extensive basal polyps and low narrow pelvis patients with rectal cancer, is an alternative method of preserving anus radical. Professor Zhang Dongming of Second Military Medical University Department of anatomy of the pelvic floor tunnel according to the theory of bowel function is mainly composed of the external anal sphincter and puborectalis and anal sphincter control, only the continuation of the rectal wall, with no effect on bowel function, so, for the super low rectal cancer patients, along with rectal sphincter resection of rectal cancer, and surgery pull down the colon and anal sphincter reconstruction not only thorough resection of anal suture and retention of anal function, but do not have to worry about the anastomotic leakage, can greatly save the medical expenses for the patient (without stapler and suture device). This new concept is being accepted by more and more surgeons.

 

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