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腹会阴联合切除术(abdomino-perineal excision,APE)曾是直肠癌的标准手术治疗术式,其由Miles于100多年前提出并以其名字命名该术式。Miles手术范围较大,术中经会阴切除坐骨直肠窝脂肪及全部肛提肌。在Heald提出全直肠系膜切除(total mesorectal excision,TME)及吻合器推广应用之后,直肠癌的保肛手术比例增加,Miles手术的比例逐渐下降,多用于低位直肠癌,而且Miles手术的切除范围也较前缩小,术中一般未切除全部肛提肌,而是仅切除
Abdomino-perineal excision (APE) was once a standard surgical procedure for rectal cancer, which was proposed by Miles over 100 years ago and naming it under its own name. Miles larger scope of surgery, intraoperative perineal resection of the rectum fossa fat and all levator ani muscle. After Heald proposed the application of total mesorectal excision (TME) and stapler, the proportion of anal sphincter preservation in rectal cancer increased. The proportion of Miles surgery gradually decreased, which was mostly used in low rectal cancer. And the range of Miles excision Shrink compared with the previous surgery, the general excision of all levator ani, but only removed