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目的探讨应用经肛内外括约肌间切除术治疗低位直肠癌的术后肿瘤学效果及其影响因素。方法复习应用经肛内外括约肌间切除术治疗低位直肠癌的报道,总结此术式的肿瘤学效果及其影响因素。肿瘤学效果主要包括:局部复发与远处转移、术后生存率和死亡率。影响因素包括:患者肿瘤学指标、手术操作、围手术期放化疗等。结果经肛内外括约肌间切除术后肿瘤复发率、生存率、死亡率等与传统术式相似。肿瘤分期较高、存在转移及手术操作不规范会严重影响术后肿瘤学效果;术前放化疗的应用可提高术后肿瘤学效果,但可能影响术后肛门功能。结论经肛内外括约肌间切除术后的肿瘤学效果是可以接受的,为提高其效果还需仔细筛选患者,并合理安排放化疗。
Objective To investigate the postoperative and postoperative effects of transanal internal and external sphincterotomy on low rectal cancer and its influencing factors. Methods Review the application of transanal internal and external sphincterotomy for the treatment of low rectal cancer, summarizing the surgical effects and its influencing factors. Oncological effects include: local recurrence and distant metastasis, postoperative survival and mortality. Influencing factors include: oncological indicators of patients, surgical operations, perioperative radiotherapy and chemotherapy. Results The recurrence rate, survival rate, and mortality rate after intra-and external anal sphincter resection were similar to those of conventional surgery. Higher tumor staging, presence of metastases, and non-standard surgical procedures can severely affect postoperative oncologic effects; preoperative chemoradiotherapy may improve postoperative oncologic efficacy but may affect postoperative anal function. Conclusions The oncological effects after internal and external anal sphincterotomy are acceptable. To improve its effect, it is necessary to carefully screen patients and arrange chemoradiotherapy rationally.