直腸癌手術治療之現況

Surgery for Rectal Cancer: The State of the Art

江支銘(Jy-Ming Chiang)

《中華民國癌症醫學會雜誌》 24卷3期 (2008/06) Pp. 167-171

https://doi.org/10.6588/JCOS.2008.24.3.4

摘要

直腸癌之手術治療，需根據癌病之診斷與分期，及病人本身之身體狀況，選擇合適之手術方法。良性或早期直腸癌可以考慮經肛門局部切除手術，或經肛門內視鏡顯微手術，其他患者則應接受根治性切除手術，宜包含全直腸腸繫膜切除，並選擇適當之幅射性邊緣與遠端邊緣。對於局部侵犯嚴重之直腸癌，術前結合放射線及化學藥物治療可以提高切除率，並減少永久性人工肛門之機會。對於術後排便、排尿及性功能之改變，亦應提供適當之治療與諮詢。

關鍵字

直腸癌 ； 手術 ； 全直腸腸繫膜切除

並列摘要

To achieve optimal management of rectal cancer, considerations should include the diagnosis and staging of the disease as well as physical condition of the patient. For benign lesion or early rectal cancer, transanal excision or transanal endoscopic microsurgery may be considered. For more advanced rectal cancer, radical resection with lymph node dissection is necessary. Ideally, total mesorectal excision should be included, with adequate distal and radical margins. For locally advanced rectal cancer, preoperative combined chemoradiation therapy may increase resectability and decrease the opportunity of permanent colostomy. Regarding associated functional changes of defecation, voiding and sexual function after operation, appropriate treatment and counsel should be provided.

並列關鍵字

rectal cancer ； surgery ； total mesorectal excision