中国实用外科杂志2026，Vol.46Issue(2)：202-205,4.DOI:10.19538/j.cjps.issn1005-2208.2026.02.08
从解剖、功能与肿瘤学平衡角度分析超低位直肠癌适形经括约肌间切除术的价值
The value of conformal intersphincteric resection for ultralow rectal cancer:achieving balance among anatomy,function,and oncology
摘要
Abstract
Conformal Intersphincteric Resection(ISR)repre-sents an evolution in the surgical philosophy for ultralow rectal cancer,shifting from the paradigm of"maximal sphincter pres-ervation"to that of"functional sphincter preservation."At its core,the procedure involves a precise,tumor-conformal exci-sion and reconstruction based on the individualized pattern of tumor invasion into the anal sphincter complex,aiming to bal-ance radical oncological clearance with functional preserva-tion.The surgery achieves this through a conformal incision,three-dimensional dissection within the intersphincteric plane,and a precise"rendezvous"between the abdominal and perineal approaches.This ensures complete tumor removal while maximally protecting the external sphincter-puborectalis complex,which is critical for active continence.The successful implementation of conformal ISR integrates three principal ob-jectives:oncological radicality,anatomical precision,and func-tional preservation.It relies on meticulous preoperative plan-ning,millimeter-accurate intraoperative technique,and func-tion-oriented perioperative management.With advances in minimally invasive and navigation technologies,conformal ISR is progressing toward greater precision,offering more patients the potential to achieve the dual goals of cancer cure and func-tional preservation.关键词
超低位直肠癌/经括约肌间切除术/适形经括约肌间切除术/功能保肛Key words
ultra-low rectal cancer/intersphincteric resection/conformal intersphincteric resection/functional sphincter preservation分类
医药卫生引用本文复制引用
李杨,杨正阳,石晋瑶,高加勒,宋建宁,吴国聪,姚宏伟,张忠涛..从解剖、功能与肿瘤学平衡角度分析超低位直肠癌适形经括约肌间切除术的价值[J].中国实用外科杂志,2026,46(2):202-205,4.基金项目
国家科技重大专项-四大慢病防治研究项目(No.2024ZD0520302) （No.2024ZD0520302）
北京市医院管理中心扬帆计划临床技术创新项目(No.ZLRK202302) （No.ZLRK202302）
首都医科大学结直肠肿瘤临床诊疗与研究中心专项基金项目(No.1192070313) （No.1192070313）
首都医科大学结直肠癌免疫治疗基础-临床联合实验室项目(No.2023-175) Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2024ZD0520302) （No.2023-175）
Beijing Hospitals Authority Clinical Medicine Development of special funding support(No.ZLRK202302) （No.ZLRK202302）
Program of Clinical Center for Colorectal Cancer of Capital Medical University(No.1192070313) （No.1192070313）
Capital Medical University Basic-Clinical Joint Laboratory Project Fund for Colorectal Cancer Immunotherapy(No.2023-175) （No.2023-175）
