| 摘要 |
A technique for reconstructing the pelvic diaphragm in the abdominal-anal resection of rectum due to cancer consists in the mobilization of the rectum with cancer, the preparation of the viable sigmoid graft, the mobilization of the anal canal by the perineal access, the graft exteriorization to the perineum, and the formation of the perianal anastomosis. In the course of the perineal stage of the surgery, the sacral fascia is dissected and the canal to the peritoneal cavity is generated. By the traction with the finger caudally from the small pelvis towards the anal canal, the muscular complex is separated comprising the internal sphincter of rectum, the elements of the puborectal muscle, and the anal levators. Through the tailored muscular cuff comprising the subcutaneous portion of external sphincter of rectum, the internal sphincter of rectum, the puborectal muscle, and the anal levators, the rectum with cancer is extracted, the sigmoid graft is exteriorized. Finally, the peritoneal cavity is sutured layer-by-layer. |
