国内外经肛全直肠系膜切除术结构化培训的开展历程和新要求  

The development process and new requirements of structured training on transanal total mesorectal resection

作　　者：高加勒 安勇博 姚宏伟[1] 张忠涛[1] Gao Jiale;An Yongbo;Yao Hongwei;Zhang Zhongtao(Department of General Surgery,Beijing Friendship Hospital,Capital Medical University,Key Laboratory of Cancer Invasion and Metastasis Research&National Clinical Research Center for Digestive Diseases,Beijing,Clinical Practice and Research Center for Colorectal Cancer,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研究中心肿瘤侵袭和转移机制研究北京市重点实验室首都医科大学结直肠肿瘤临床诊疗与研究中心,100050

出　　处：《中华外科杂志》2021年第5期328-331,共4页Chinese Journal of Surgery

基　　金：国家科技支撑计划(2015BAI13B09);国家重点研发计划(2017YFC0110904);北京市医院管理局临床医学发展专项基金(ZYLX201504);首都医科大学附属北京友谊医院科研启动基金(YYQDKT2016-5);首都医科大学结直肠肿瘤临床诊疗与研究中心基金项目(1192070313)。

摘　　要：经肛全直肠系膜切除术技术难度较大、学习曲线长,过快地大规模开展所致的并发症可能掩盖其优点,术者需要在实施此类手术之前接受充分的培训。目前,国内外已经形成了较为成熟的"结构化培训"体系,然而培训的开展并未满足现有手术发展的需求。为规范taTME的发展,欧洲结直肠疾病学会联合国际14个相关学会于近期推出了《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指南》,其中对结构化培训做了重点推介,内容包括对学员的要求,培训的内容和流程,培训结果的评估与登记等。尸体手术训练是结构化培训的核心,初学者应反复接受培训,并在教员的指导下开展该手术。Due to the technical difficulty and long learning curve,the benefits of Transanal total mesorectal excision may be obscured by surgical complications that arise from rapid,large-scale development,therefore the surgeons need to receive sufficient training before performing this surgery.At present,a mature structured training system has been formed,but the development of structured training has not met the needs of existing surgical development.In order to standardize the development of transanal total mesorectal excision,the European Society of Colorectal Diseases and 14 international surgical societies recently launched the"International Expert Consensus Guidelines for the Indication,Implementation and Quality Evaluation of Transanal Total Mesorectum Resection".The consensus involves the requirements for trainees,the content and process of training,as well as the evaluation and registration of training results.Training in cadaver is the core of structured training.Beginners should receive repeated training and conduct the surgery under the guidance of instructors.

关 键 词：直肠肿瘤 直肠结肠切除术 重建性 经肛全直肠系膜切除术 结构化培训 指南 学习曲线 

分 类 号：R735.37[医药卫生—肿瘤]