经肛门全直肠系膜切除术后肛门功能评估方法及现状  

Evaluation method and current situation of anal function after total mesorectal excision

作　　者：季萌萌 刘晓平[2] 刘政 江峰 金方童 JI Meng-meng;LIU Xiao-ping;LIU Zheng;JIANG Feng;JIN Fang-tong(Gannan Medical University,Gannan Medical University,Ganzhou,Jiangxi 341000;The Fifth Department of General Surgery,The First Affiliated Hospital of Gannan Medical University)

机构地区：[1]赣南医学院,江西赣州341000 [2]赣南医学院第一附属医院普外五科

出　　处：《赣南医学院学报》2022年第10期1105-1109,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省教育厅课题(GJJ180810);江西省卫生健康委员会课题(202210908)。

摘　　要：在过去的几十年中,经腹会阴的直肠切除术(Miles手术)是低位直肠癌最常见的术式。全结肠系膜切除(Total mesorectal excision,TME)理念的提出为低位直肠癌的保肛提供了理论依据。经肛全直肠系膜切除术(Transanal total mesorectal excision,TaTME)则是基于TME理念而发展起来的低位直肠癌保肛创新术式,TaTME是近年的新兴技术,该术式的主要争议点在于是否保留了肛门功能,目前术后的肛门功能恢复情况主要通过各种量表来评估,而盆底肌电图、肛管直肠测压、肛管内超声等在临床运用较少。术后肛门功能评估方法单一及缺乏足够数量的术后随访数据,使得术后肛门的远期功能恢复不明确。传统直肠癌保肛术后早期肛门功能可能优于TaTME,但有研究认为,两者术后中期及远期的肛门功能方面差异不大。本文主要对TaTME术后肛门功能评估方法及现状进行综述。In the past few decades,transabdominal perineal rectectomy(Miles operation)is the most common operation for low rectal cancer. Transanal total mesorectal excision(TaTME)is an innovative operation to preserve the anus of low rectal cancer on the basis of TME. TaTME is an emerging technology in recent years. The main controversial point of this operation is whether to retain the anal function. At present,the recovery of anal function after operation is mainly evaluated by various scales,while instrument evaluation methods such as anorectal manometry,intraanal ultrasound and pelvic floor electromyography are rarely used. The single method of postoperative anal function assessment and the lack of sufficient postoperative follow-up data make the long-term functional recovery of the postoperative anus unclear. The early anal function after traditional rectal cancer sphincter preservation may be better than TaTME. However,according to some studies,there is little difference in the anal function between the two in the mid-term and long-term after surgery.This paper will mainly review the methods and current situation of anal function evaluation after TaTME.

关 键 词：直肠癌 经肛门全直肠系膜切除术 肛门功能 

分 类 号：R657.1[医药卫生—外科学]