经肛全直肠系膜切除术易损伤区域及术中处理策略  

Vulnerable areas and intraoperative management strategies of transanal total mesorectal excision

作　　者：赵世栋 叶颖江[1] 申占龙[1] Zhao Shidong;Ye Yingjiang;Shen Zhanlong(Department of Gastroenterological Surgery,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,北京100044

出　　处：《结直肠肛门外科》2024年第2期159-162,共4页Journal of Colorectal & Anal Surgery

摘　　要：经肛全直肠系膜切除术经过十余年的发展和实践,凭借其在低位直肠癌根治术中良好的手术视野,得到了越来越多结直肠外科医师的认可。但由于经肛全直肠系膜切除术是“由尾向头”的操作视角,结直肠外科医师需要正确认识相关的解剖层面及标志,以便获得更高的手术质量。本文围绕肛门括约肌、骶前静脉、神经血管束、盆丛后支及男性尿道这5个经肛全直肠系膜切除术易损伤区域以及相关操作要点进行阐述,并提出术中处理策略。Transanal total mesorectal resection(taTME)has been developed and practiced for more than 10 years and has been recognized by more and more colorectal surgeons due to its good surgical vision during the radical resection of low rectal cancer.However,due to its“caudal to cranial”operating perspective,colorectal surgeons need to correctly understand the relevant anatomical levels and markers in order to achieve higher surgical quality.In this paper,the five vulnerable areas of taTME,including anal sphincter,anterior sacral vein,neurovascular bundle,posterior branch of pelvic plexus and male urethra,as well as relevant operation points,were described,and intraoperative management strategies were proposed.

关 键 词：经肛全直肠系膜切除术 “由尾向头” 易损伤区域 操作要点 处理策略 

分 类 号：R735.3[医药卫生—肿瘤]