本文選題：直腸癌 + 肛提肌外腹會(huì)陰聯(lián)合切除術(shù)��； 參考：《中華腫瘤防治雜志》2017年09期

【摘要】：目的肛提肌外腹會(huì)陰聯(lián)合切除術(shù)(exralevator abdominoperineal excision,ELAPE)的提出旨在改善低位直腸癌的手術(shù)安全性和腫瘤預(yù)后,但其應(yīng)用仍存在爭議。本研究總結(jié)ELAPE治療低位直腸癌的最新研究進(jìn)展。方法應(yīng)用PubMed及CNKI期刊全文數(shù)據(jù)庫檢索系統(tǒng),以"肛提肌外、腹會(huì)陰聯(lián)合切除術(shù)和低位直腸癌"為關(guān)鍵詞,檢索2006-01-2015-12的相關(guān)文獻(xiàn)。納入標(biāo)準(zhǔn):(1)ELAPE的療效分析;(2)ELAPE術(shù)后并發(fā)癥的處理;(3)ELAPE的適用范圍;(4)ELAPE體位的選擇。排除標(biāo)準(zhǔn):(1)綜述和會(huì)議匯編等相關(guān)文獻(xiàn);(2)實(shí)驗(yàn)設(shè)計(jì)不嚴(yán)謹(jǐn)。根據(jù)納入和排除標(biāo)準(zhǔn),符合分析53篇,其中英文文獻(xiàn)45篇,中文文獻(xiàn)8篇。結(jié)果手術(shù)是低位直腸癌的首選治療方案,ELAPE作為治療低位直腸癌新的術(shù)式,目前其手術(shù)體位,術(shù)后盆底重建,手術(shù)療效及適用范圍等方面存在諸多爭議,仍需要進(jìn)一步探討,尤其是手術(shù)療效及患者術(shù)后生活質(zhì)量亟需進(jìn)一步的前瞻性研究來驗(yàn)證。結(jié)論 ELAPE尚不能取代傳統(tǒng)腹會(huì)陰聯(lián)合切除術(shù)(abdominoperineal excision,APE)而成為治療低位直腸癌的標(biāo)準(zhǔn)術(shù)式,ELAPE術(shù)式可能還需要進(jìn)一步優(yōu)化和改進(jìn)。
[Abstract]:Objective to improve the safety and prognosis of low rectal cancer by exralevator abdominoperineal excisioning combined excision of levator ani and ventral perineum, but its application is still controversial. This study summarizes the latest advances in the treatment of low rectal cancer with ELAPE. Methods by using the PubMed and CNKI full text database retrieval system, we searched the relevant literature of 2006-01-2015-12 with the key words of "Extra-levator muscle, combined abdominal perineum resection and low rectal cancer". Treatment of postoperative complications of ELAPE and the selection of position of ELAPE. Exclusion Standard: 1) Review and Conference Compendium, etc.) the experimental design is not rigorous. According to the criteria of inclusion and exclusion, there were 53 articles in accordance with the analysis, including 45 articles in Chinese and 45 articles in Chinese, and 8 articles in Chinese. Results Operation is the first choice for the treatment of low rectal cancer. At present, there are many controversies in the position of operation, the reconstruction of pelvic floor after operation, the curative effect and the scope of application, and so on, which still need to be further discussed. In particular, the efficacy of surgery and postoperative quality of life need further prospective research to verify. Conclusion ELAPE can not replace the traditional abdominal perineum combined excision (abdominoperineal excision) and become the standard procedure for the treatment of low rectal cancer.
【作者單位】： 威海市立醫(yī)院胃腸外科;
【基金】：威海市科技發(fā)展計(jì)劃(2015FZA01005)
【分類號】：R735.37

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