CAJ | 학술논문

目的：探讨腹腔镜经肛提肌腹会阴联合切除术（translevator abdominoperineal resection， TLAPR）治疗低位直肠癌的初步临床应用结果。方法分析上海中医药大学附属曙光医院普外科于2012年1月到2012年2月对3例低位直肠癌患者，在腹腔镜下完成经肛提肌腹会阴联合切除术的临床资料。结果本组3例患者均顺利完成手术，无中转开腹，未发生手术并发症。平均手术时间122 min，标本环周切缘均为阴性。3例患者术后平均随访21.3个月，无局部复发、远处转移，随访至今无死亡病例。结论腹腔镜经肛提肌腹会阴联合切除术治疗低位直肠癌安全、可行，可降低术中穿孔发生率，能降低环周切缘阳性率，短期随访预后良好。
목적：탐토복강경경항제기복회음연합절제술（translevator abdominoperineal resection， TLAPR）치료저위직장암적초보림상응용결과。방법분석상해중의약대학부속서광의원보외과우2012년1월도2012년2월대3례저위직장암환자，재복강경하완성경항제기복회음연합절제술적림상자료。결과본조3례환자균순리완성수술，무중전개복，미발생수술병발증。평균수술시간122 min，표본배주절연균위음성。3례환자술후평균수방21.3개월，무국부복발、원처전이，수방지금무사망병례。결론복강경경항제기복회음연합절제술치료저위직장암안전、가행，가강저술중천공발생솔，능강저배주절연양성솔，단기수방예후량호。
Objectives To explore the preliminary application result of laparoscopic translevator abdominoperineal resection (TLAPR)for low rectal cancer. Methods The clinical data of 3 patients with low rectal cancer performed Lap-TLAPR were analyzed from January 2012 to February 2012,in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. Results All the procedures were successfully performed without any complications,or conversion to the open approach.The mean operation time was 122 minutes.All the specimens had negative circumferential margins. The mean follow-up period of 3 patients was 21.3 months,there was no local recurrence or death. Conclusions TLAPR is a safe and feasible surgical approach of low rectal cancer. TLAPR might reduce the incidence of positive CRM and intestinal perforation,and has a better prognosis than conventional abdominoperineal resection.