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首页 > 医学词汇大全 > Abdominoperineal Resection
Abdominoperineal Resection

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关键词消化 手术 直肠癌治疗

词汇介绍

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解析

abdominoperineal  [æb'dɔminə,peri'ni:əl]

释义   adj. 腹会阴的

例句   Among locally advanced rectal/rectosigmoid cases, surgery included abdominoperineal resection or low anterior resection.

局部进展性直肠/直肠乙状结肠病例,手术治疗包括腹会阴联合切除术或低位前切除术。

 

resection 英 [rɪ'sekʃn] 美 [rɪ'sekʃn]

释义   n. [外科] 切除术

例句   Local residual early cancer after endoscopic resection

内镜切除后局部残留早期癌症


概述

腹会阴联合切除术,又称Miles手术,是治疗低位直肠癌不保肛手术的标准术式。适用于肿瘤位置非常低或括约肌功能差的患者,该手术需完全切除结肠末端与直肠及肛门括约肌复合体,切除范围包括乙状结肠远端、全部直肠、肠系膜下动脉及其区域淋巴结、全直肠系膜、肛提肌、坐骨直肠窝内脂肪、肛管及肛门周围约5cm直径的皮肤、皮下组织及全部肛门括约肌,于左下腹行永久性乙状结肠单腔造口。 适应症腹膜返折以下的直肠癌,肿瘤下缘距齿线6cm以内的(如肿瘤分化低,局部浸润深,可延长到8cm以内),且无远距离转移者

Vertical Rectus Abdominis Musculocutaneous Flap Repair Improves Perineal Wound Healing after Abdominoperineal Resection for Irradiated Locally Advanced Rectal Cancer复制标题

垂直腹直肌肌皮瓣修复局部晚期直肠癌腹会阴联合切除术后会阴创面愈合

发表时间:2018-11-20

影响因子:3.7

作者: Milan Spasojevic

期刊:Ann Surg Oncol

Treatment of low locally advanced rectal cancer (LARC) frequently requires abdominoperineal resection (APR), often in combination with multivisceral resections,1 resulting in a large dead space in the pelvic cavity and the risk of non-tension-free closure of the perineal wound. In addition, the majority of the patients receive neoadjuvant (chemo) radiotherapy (C)RT, which, in combination with the above-mentioned factors, predisposes patients to surgical site infection and delayed perineal wound healing.2–4 These complications contribute to prolonged hospital stay and the necessity for repeat wound debridement, adversely affecting the patients’ quality of life and significantly increasing the cost of medical treatment.5 In an attempt to reduce perineal wound morbidity, the vertical rectus abdominis musculocutaneous (VRAM) flap repair has been advocated as a valuable alternative to direct perineal wound closure, with a reported absolute risk  reduction of perineal wound complications of up to 17%.6 The rationale behind this is that the placement of nonirradiated, well-vascularized tissue to the perineal wound improves wound healing. However, due to the heterogeneity of present studies7–10 and the absence of sufficiently powered prospective studies,11 the efficacy of VRAM flap in reducing perineal wound morbidity remains uncertain. The aim of this study was to compare perineal wound morbidity after APR for LARC in patients with VRAM flap repair to direct perineal wound closure.

译文

低位局部晚期直肠癌(LARC)的治疗经常需要腹会阴切除术(APR),通常与多节段切除相结合,1导致盆腔内存在较大的死腔以及会阴伤口无张力闭合的风险。此外,大多数患者接受新辅助(化疗)放疗(C)RT,结合上述因素,使患者易于手术部位感染和延迟会阴伤口愈合.2-4这些并发症有助于延长住院和重复伤口清创的必要性,对患者的生活质量产生不利影响,并显着增加医疗费用.5为了减少会阴伤口的发病率,已提倡垂直腹直肌肌皮瓣(VRAM)皮瓣修复作为直接会阴伤口闭合的有价值的替代方案,报告的会阴伤口并发症的绝对风险降低高达17%.6其背后的理由是将未经辐射的,血管良好的组织放置在会阴伤口处可改善伤口愈合。然而,由于目前研究的不均匀性7-10以及缺乏足够动力的前瞻性研究[11],VRAM皮瓣在降低会阴伤口发病率方面的功效仍不确定。本研究的目的是比较VRAM皮瓣修复患者的LARC APR后会阴伤口发病率与直接会阴伤口闭合情况。