直肠系膜全切除的解剖学基础  

The anatomic basis of total mesorectal excision

作　　者：林谋斌[1] 陈伟国[1] 金志明[1] 倪金迪[1] 倪俊声[1] 尹路[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院普外科,200025

出　　处：《中华医学杂志》2008年第5期299-301,共3页National Medical Journal of China

基　　金：上海市科委基金资助项目（074119602）;上海市癌症研究中心基金资助项目（G05879）

摘　　要：目的探讨直肠系膜全切除（TME）的解剖学基础，明确TME的切除平面。方法对23具尸体的盆腔进行解剖，观察直肠系膜与周围筋膜、神经的关系。结果直肠周围的层次是连续的，可以分为3个层次，由内向外依次为脏筋膜、膀胱腹下筋膜、壁筋膜。层次之间存在不同的神经结构。结论TME的切除应包括脏筋膜在内，解剖层次应为脏、壁筋膜之间，正确的层次在直肠后方可用腹下神经、侧方可用盆丛来加以判断。Objective To clarify the anatomic basis and present the accurate plane of total mesorectal excision （TME）. Method 23 pelvises （12 male and 11 female） harvested from embalmed cadavers were studied by dissection. The relationships of the ＂mesorectum＂ with the fascias and nerves of the pelvic cavity were observed. Results Three layers were found surround the rectum and different nerve existed in different layers. Visceral fascia, parietal fascia and vesicohypogastric fascia were found side by side in a inside-outside direction. Conclusion The layer of TME dissection contains visceral fascia. The correct layer of posterior and lateral resection can be identified by hypogastric nerve and pelvic plexus respectively.

关 键 词：直肠 解剖 肠系膜 直肠系膜全切除 

分 类 号：R686[医药卫生—骨科学]