多学科团队诊断与治疗模式在规范开展经肛全直肠系膜切除术中的应用价值  

Application value of multidisciplinary team model in normatively carrying out transanal total mesorectal excision

作　　者：申占龙[1] 叶颖江[1] 尹慕军[1] 高志冬[1] 曹键[1] 赵龙[1] 王杉[1] Shen Zhanlong;Ye Yingjiang;Yin Mujun;Gao Zhidong;Cao Jian;Zhao Long;Wang Shan(Department of Gastroenterological Surgery,Laboratory of Surgical Oncology,Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research,Peking University People′s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院胃肠外科,北京大学人民医院外科肿瘤研究室,北京市结直肠癌诊疗研究重点实验室,100044

出　　处：《中华消化外科杂志》2020年第1期59-62,共4页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金面上项目(81672375)。

摘　　要：经肛全直肠系膜切除术(TaTME)是治疗低位直肠癌的一种新兴手术方式,其以远端直肠手术良好的视野显露和超低位保肛等优势得到认可和推广。目前国内外相关诊断与治疗指南均推荐直肠癌的治疗需要经多学科团队(MDT)讨论决定。MDT已成为直肠癌患者得到规范化治疗的制度性诊断与治疗模式。直肠癌TaTME手术适应证的选择依赖MDT模式下术前影像学检查精准分层、复发危险度判断。规范的MDT术前评估、多学科研讨作出决策是TaTME获得规范化实施和合理推广的保障。同时,TaTME作为一种可能改善直肠肿瘤疗效的手术方式,使部分患者在基于影像学检查准确分期的基础上免去术前放化疗,从而调整外科手术在MDT模式中的地位,为优化直肠癌整体疗效和卫生经济学做出贡献。With certain advantages of superior surgical fields and better chances for anus reservation,transanal total mesorectal excision(TaTME)is a novel surgical approach for low rectal cancer.Guidelines recommend multidisciplinary team(MDT)work as a clinical routine for standardized treatment of rectal cancer.Indication of TaTME depends on multidisciplinary discussion including preoperative staging,prediction of recurrence risks.Standardized preoperative evaluation by MDT and decisions after MDT discussion are the guarantee for the stan-dardized implementation and reasonable promotion of TaTME.Meanwhile,as a procedure for improving local efficacy of rectal cancer,TaTME could save a part of patients with low rectal cancer the trouble of neoadjuvant chemoradiotherapy based on accurate staging by radiologists.That might upgrade status of colorectal surgeons in the MDT and contribute to optimize both curative effects and health economics.

关 键 词：直肠肿瘤 经肛全直肠系膜切除术 多学科团队 手术 规范化 诊断 治疗 模式 

分 类 号：R735[医药卫生—肿瘤]