随着经肛门结肠肛管吻合技术的发展和钉书机吻合技术的引进,使得患有低位直肠癌的病人恢复消化道连续性成为可能。这些技术的进展实际上必然使保留括约肌的直肠癌切除术得以开展,从而显著地减少了经腹会阴切除术的数目。然而,许多外科医师持相反意见。他们认为在保留括约肌切除术(SSR)时,组织切除不如经腹会阴切除术(APER)来得广泛,复发率和生存率必将受到影响。如果为了保留肛门括约肌而使通常的远端清除5cm 的边缘不能得到保证,则由于显微镜下的远端播散得不到充分处理,其局部复发率将迅速上升。他们还认为盆腔深部作吻合很可能产生瘘,从而使死亡率和病残率增高。此外,尽管 With the development of transanal colon anal canal anastomosis and the introduction of stapler anastomosis technology, it has become possible for patients with low rectal cancer to restore gastrointestinal continuity. The advancement of these techniques actually inevitably led to the development of rectal cancer resection of the sphincter, which significantly reduced the number of transabdominal perineal resections. However, many surgeons hold opposing opinions. They believe that when sphincterotomy (SSR) is preserved, tissue resection is not as widespread as transabdominal perineal resection (APER), and recurrence rate and survival rate are bound to be affected. If the usual distal clearance of 5 cm cannot be ensured in order to preserve the anal sphincter, the local recurrence rate will increase rapidly because the distal dispersal under the microscope is not sufficiently processed. They also believe that deep pelvic anastomosis is likely to produce paralysis, which will increase mortality and morbidity. In addition, despite