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对于末段(距肛缘4.0～5.0cm)直肠癌仍几乎无法保留肛门或同时达到保肛及根治两个目标。内括约肌切除(ISR)保肛手术用于部分符合要求的末段直肠癌患者,既可达到保留肛门功能的目的,又同时能达到根治的目的,有希望成为末段直肠癌优先选择的手术方式,然而尚有部分问题没有明确。笔者仅就ISR技术的解剖、病理生理学基础,ISR在直肠癌治疗中的适应证、禁忌证、手术技术以及患者术后的生存率、局部复发率、病死率、并发症等诸方面作一文献综述。
For the final paragraph (from the anal verge 4.0 ~ 5.0cm) rectal cancer is still almost impossible to retain the anus or at the same time to protect the anus and cure two goals. Internal sphincterotomy (ISR) anal sphincter preservation surgery for some of the patients with end-stage rectal cancer, both to achieve the purpose of preserving the anus function, while at the same time can achieve the purpose of radical, hope to become the preferred surgical treatment of distal rectal cancer However, there are still some problems that are not clear. The author only made a literature on the anatomy of ISR, the basis of pathophysiology, ISR indications in the treatment of rectal cancer, contraindications, surgical techniques and postoperative survival, local recurrence, mortality, complications, etc. Summary.