直肠癌柱状经腹会阴切除术

柱状经腹会阴切除术(肛提肌外腹会阴切除术)作为直肠癌的一种新术式，较常规经腹会阴切除术可以切除更多的癌周组织，减少术中穿孔，降低环周切缘阳性率，从而达到改善预后的目的。作者在国内率先开展本术式，并创新性使用生物材料进行盆底重建，不但简化了手术，而且减少手术并发症发生的机会，使本术式更加安全可靠。笔者详细介绍了柱状腹会阴切除术操作要点和注意事项，阐述了本术式的优势和发展前景，柱状经腹会阴切除术有望成为无法保肛直肠癌患者的标准术式。

Cylindrical abdominoperineal resection for rectal cancer

Cylindrical abdominoperineal resection(cAPR), also named extra-levator abdominoperineal excision(ELAPE) compared with conventional APR, can remove much volume of tissues arround rectal cancer so as to reduce the circumferential margin positive and rectum perforation rate.The author of this article is the first one who introduced cAPR(ELAPE) to China and successfully used the biological material to repaire the pelvic defect after cAPR in the world.Using biological materials to reconstruct the pelvic floor can simplify the operation and reduce the incidence of operative complications.The key points and notes of cAPR are introduced in this paper.The author described the advantages and prospects of cAPR.The procedure of cAPR is expected to be a standard operation for rectal cancer that failed to preserve sphincter.