低位直肠癌保肛手术的质量控制

 随着对盆腔解剖和直肠癌生物学特性认识的加深，越来越多的低位直肠癌患者能够保留肛门，保肛手术已成为目前临床上治疗直肠癌最常用的术式。高质量的手术需要同时在肿瘤学和功能学方面使患者受益，因而低位直肠癌保肛手术需兼顾肿瘤根治和肛门功能。全直肠系膜切除（total mesorectal excision，TME）原则、安全的远切缘和环周切缘是保证肿瘤学效果的关键，能够有效降低直肠癌局部复发率和远处转移率。而保留更多的肛门括约肌以及术中对盆腔植物神经的保护则是改善术后肛门功能，提高患者生活质量的重要因素。  

Quality control of sphincter preserving surgery in low rectal cancer

More and more patients with low rectal cancer could receive sphincter preserving surgery with the development of knowledge in pelvic anatomy and biological characteristics of rectal cancer and sphincter preserving surgery has become the most common method to treat low rectal cancer. Patients will benefit from the high quality surgery which gives consideration to both oncology outcome and anal function. Total mesorectal excision, distal margin and circumferential resection margin are the key points that can reduce the local recurrence rate and metastasis rate. Meanwhile, preserving more anal sphincter and pelvic autonomic nerve can improve the anal function and quality of life after surgery.