2020年《经肛全直肠系膜切除手术适应证、实施和质量评估的国际专家共识和指南》要点解读  

Interpretation of international expert consensus guidance on indications,implementation and quality measures for transanal total mesorectal excision

作　　者：姚宏伟[1] 高加勒 安勇博 张忠涛[1] Yao Hongwei;Gao Jiale;An Yongbo;Zhang Zhongtao(Department of General Surgery,National Clinical ResearchCenter for Digestive Diseases,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院普通外科国家消化系统疾病临床医学中心,100050

出　　处：《中华胃肠外科杂志》2021年第4期314-318,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：国家科技支撑计划课题(2015BAI13B09);国家重点研发计划资助(2017YFC0110904);北京市临床重点专科基金(卓越项目2018-118);北京市医院管理局临床医学发展专项基金(ZYLX201504);首都卫生发展科研重点项目(首发2018-1-1111);首都医科大学结直肠肿瘤临床诊疗与研究中心基金(1192070313);首都医科大学附属北京友谊医院科研启动基金(YYQDKT2016-5)。

摘　　要：经肛全直肠系膜切除(taTME)是结直肠外科领域近年来的热点术式。相比传统腹腔镜全直肠系膜切除技术,taTME在治疗直肠疾病中有潜在的优势。然而,其手术安全性和有效性(包括手术并发症及肿瘤学效果等),仍有待进一步的研究结果验证。为保障该技术安全规范地实施,欧洲结直肠疾病学会联合国际上14个结直肠外科及微创外科相关的学术组织,推出了《经肛全直肠系膜切除术适应证、实施和质量评估的国际专家共识和指南》(下简称《taTME国际共识指南》)。本文介绍了该国际共识指南的制定背景,并针对其核心内容,包括taTME的手术适应证(复杂骨盆条件、直肠恶性疾病和直肠良性疾病)、手术质量和结果评估、结构化培训和专家中心进行了详细解读,期待为中国结直肠外科同行开展taTME供参考和指导。In recent years,transanal total mesorectal excision(taTME)has been a hot spot in the field of colorectal surgery.Compared with the traditional laparoscopic technique,taTME has potential advantages in the treatment of rectal diseases.However,the procedural safety and effectiveness of taTME need further verification.In order to ensure the safe and standardized implementation of this procedure,the European Society of Coloproctology,together with 14 international academic organizations related to colorectal surgery and minimally invasive surgery,has developed the international expert consensus guidance on indications,implementation and quality measures for taTME.This paper introduces the background of the international consensus guidance,and interprets its core contents,including the surgical indications(complex pelvic conditions,malignant and benign rectal diseases),surgical quality and outcome evaluation,structured training,and expert center.It is expected to provide reference and guidance for Chinese colorectal surgery colleagues performing taTME.

关 键 词：直肠肿瘤 经肛全直肠系膜切除 国际专家共识 指南 

分 类 号：R735.37[医药卫生—肿瘤]