结直肠肛门外科2025，Vol.31Issue(6)：527-531,5.DOI:10.19668/j.cnki.issn1674-0491.2025.06.005
经括约肌间切除术消化道重建的技术优化:鉴于联合纵肌的"锚定"作用
Technical optimization of digestive tract reconstruction in intersphincteric resection:consid-ering the"anchoring effect"of the conjoined longitudinal muscle
岳雨杉 1厉金雷 2叶星照 1严夏霖 1徐昶1
作者信息
- 1. 温州医科大学附属第一医院结直肠肛门外科 浙江 温州 325005
- 2. 温州医科大学 浙江 温州 325035
- 折叠
摘要
Abstract
Intersphincteric resection(ISR),through meticulous dissection in the intersphincteric space and coloanal anas-tomosis to restore digestive tract continuity,offers the hope of anal preservation for patients with ultra-low rectal cancer(tumor lower edge within 5 cm of the anal verge).However,ISR is associated with a relatively high incidence of anasto-motic leakage,and high anastomotic tension is one of the contributing factors.The conjoined longitudinal muscle plays a role in"anchoring"the anal sphincter complex and coordinating defecation,yet this anatomical structure is often over-looked.The potential value of the conjoined longitudinal muscle as a reference for digestive tract reconstruction in ISR is also frequently neglected.Considering its"anchoring effect",our team proposes technical optimization of digestive tract reconstruction in ISR.By employing reinforcement suturing techniques to optimize the reconstruction procedure and re-build the"anchoring"structure between the neorectum and the anal canal,anastomotic tension can be reduced.Simulta-neously,this approach facilitates more coordinated,integrated movement at this site,which differs from the traditional practice of restoring continuity with a single-layer anastomosis.Our team believes this optimization may help reduce the risk of anastomotic leakage and demonstrates good feasibility.关键词
直肠癌/经括约肌间切除术/联合纵肌/吻合口漏Key words
rectal cancer/intersphincteric resection/conjoined longitudinal muscle/anastomotic leakage分类
医药卫生引用本文复制引用
岳雨杉,厉金雷,叶星照,严夏霖,徐昶..经括约肌间切除术消化道重建的技术优化:鉴于联合纵肌的"锚定"作用[J].结直肠肛门外科,2025,31(6):527-531,5.
