对直肠系膜的再认识  

A new insights of mesorectum

作　　者：王娟 高庆坤 王云帆[2,3,5] 张卫光 顾晋[2,3,4,7,8] Wang Juan;Gao Qingkun;Wang Yunfan;Zhang Weiguang;Gu Jin(Department of Radiology,Peking University Shougang Hospital,Beijing 100144,China;Center for Precision Diagnosis and Treatment of Colorectal Cancer and Inflammatory Diseases,Peking University Health Science Center,Beijing 100191,China;Colorectal Cancer Centre of Peking University Shougang Hospital,Beijing 100144,China;Department of Gastrointestinal Surgery,Peking University Shougang Hospital,Beijing 100144,China;Department of Pathology,Peking University Shougang Hospital,Beijing 100144,China;Department of Human Anatomy&Histology and Embryology,Peking University Health Science Centre of Basic Medical Sciences,Beijing 100191,China;Department of Gastrointestinal Surgery III,Peking University Cancer Hospital&Institute,Beijing 100142,China;Peking-Tsinghua Center for Life Science,Beijing 100142,China)

机构地区：[1]北京大学首钢医院医学影像科,北京100144 [2]北京大学医学部结直肠肿瘤与炎症性疾病精准诊治中心,北京100191 [3]北京大学首钢医院结直肠肿瘤诊疗中心,北京100144 [4]北京大学首钢医院胃肠外科,北京100144 [5]北京大学首钢医院病理科,北京100144 [6]北京大学医学部基础医学院人体解剖学与组织学胚胎学系,北京100191 [7]北京大学肿瘤医院胃肠肿瘤中心三病区,北京100142 [8]北大-清华生命科学联合中心,北京100142

出　　处：《中华胃肠外科杂志》2022年第4期321-326,共6页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金(82073223);首都卫生发展科研专项项目(首发2020-1-6041);首都临床特色应用研究(Z171100001017087)。

摘　　要：全直肠系膜切除(TME)是直肠癌根治术的"金标准"。近年来,随着影像及腹腔镜外科器械设备和技术的进步,人们对直肠系膜及周围结构的认识逐步加深,术前分期更加准确,TME手术平面更加精准,明显降低了患者术后的局部复发率,改善了远期生存。同时,自主神经系统得到比较完好的保留,最大程度地保护了患者的排尿和性功能,改善了患者术后的生活质量。正确认识直肠系膜及盆腔的解剖结构,是成功施行TME手术治疗的前提。因此,本文结合既往文献,对直肠系膜的基本概念及解剖结构进行了深入探讨,并从影像、外科及病理多学科角度,对临床相关重要问题进行了系统阐述。Total mesorectal excision(TME)represents the gold standard for radical resection in rectal cancer.The development in radiology and laparoscopic surgical equipment and the advancement in technology have led to a deepened understanding of the mesorectum and its surrounding structures.Both the accuracy of preoperative staging and the preciseness of the planes of TME surgical dissection have been enhanced.The postoperative local recurrence rate is reduced and the long-term survival of rectal cancer patients is improved.The preservation of the pelvic autonomic nervous system maintains the patient's urinary and sexual functions to the greatest extent possible,which in turn improves the patient's postoperative quality of life.A thorough understanding of the anatomy of the mesorectum and its surrounding structures is a prerequisite for successful TME.Herein,we review the basic concepts and the anatomy of the mesorectum in the current literature.Some important clinical issues are also discussed systematically in terms of imaging,surgery,and pathology.

关 键 词：直肠系膜 全直肠系膜切除 磁共振成像 病理 

分 类 号：R735.37[医药卫生—肿瘤]