骶前囊肿规范化诊疗中国专家共识(2024版)  

Chinese expert consensus on standardized treatment of presacral cyst(2024 edition)

作　　者：中国抗癌协会盆腔肿瘤整合专业委员会 中国医疗保健国际交流促进会盆腔肿瘤学分会 中国抗癌协会消化道息肉及癌前病变专业委员会 中国医师协会结直肠肿瘤专业委员会脏器联合切除与质量控制学组 王刚成 王贵英 高重庆 张志 丁亮亮 张朕 张桂祥 李硕[2] 宗富阳 Pelvic Tumor Integration Committee of China Anti-Cancer Association;Pelvic Oncology Branch of China International Exchange And Promotive Association For Medical And Healthcare;Digestive Tract Polyps and Precancerous Lesions Committee of China Anti-Cancer Association;Combined Organ Excision and Quality Control Group,Colorectal Cancer Committee of Chinese Medical Doctor Association;Wang Gangcheng;Wang Guiying(不详;Department of Abdominopelvic Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Colorectal Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050004,China)

机构地区：[1]不详 [2]郑州大学第一附属医院腹盆部肿瘤外科,郑州450052 [3]河北医科大学第二医院结直肠外科,石家庄050004

出　　处：《中华肿瘤杂志》2025年第1期76-85,共10页Chinese Journal of Oncology

摘　　要：手术切除是骶前囊肿唯一的根治性治疗手段,骶前囊肿周围解剖结构复杂,涉及重要的血管和神经,手术难度大、风险高,不当的手术方式将导致囊肿复发,给患者造成极大的痛苦。随着骶前囊肿临床研究的不断深入,一些新的问题亟待解决。中国抗癌协会盆腔肿瘤整合专业委员会在《骶前囊肿规范化诊疗中国专家共识(2021版)》基础上,组织国内相关专业领域包括普外科、胃肠外科、结直肠肛门外科、妇瘤科、骨软组织外科、神经外科、病理科、影像科等权威专家,经过共识会议制定了《骶前囊肿规范化诊疗中国专家共识(2024版)》。2024版共识从骶前囊肿的起源与病理、手术的相关解剖及分型、诊断与鉴别诊断、手术的外科理念、切除的手术方法、围手术期并发症及处理、随访以及后续治疗等七个方面进行系统介绍,经过反复讨论和修改达成共识。与2021版共识比较,2024版共识主要更新内容包括以下几方面,在解剖及分型部分,增加了高位、低位和单囊、多囊骶前囊肿的解剖分型;手术的外科理念部分增加了骶骨变异的骶前囊肿要注意保护骶神经;切除的手术方法部分进一步明确不同解剖分型骶前囊肿的手术入路,术前合并肠瘘患者应用臀大肌肌瓣修复肠瘘降低了预防性造口概率,可疑恶性骶前囊肿多学科会诊不能根治性切除后再穿刺明确病理制定综合治疗方案。2024版共识以期提高临床工作人员对骶前囊肿的认识以及指导临床工作。Surgical excision is the only radical treatment for presacral cysts,which are difficult and risky because of the complex anatomical structure around them,involving important blood vessels and nerves.Improper surgical procedures will lead to recurrence of presacral cysts after surgery,causing great pain to patients.With the deepening of clinical research on presacral cysts,some new problems have been found to be overcome.On the basis of the Chinese Expert Consensus on Standardized Treatment of Presacral Cysts(2021 edition),the Pelvic Tumor Integration Professional Committee of the Chinese Anti-Cancer Association organized authoritative experts in relevant professional fields including general surgery,gastrointestinal surgery,colorectal and anal surgery,gynecological oncology,bone and soft tissue surgery,neurosurgery,pathology,imaging and other departments,to formulate the Chinese Expert Consensus on the Standardized Diagnosis and Treatment of Presacral Cysts(2024 edition)after a consensus meeting.The 2024 consensus provides a comprehensive introduction to the following seven aspects,including the origin and pathology of presacral cysts,related anatomy and classification of surgery,diagnosis and differential diagnosis,surgical philosophy,surgical methods for excision,perioperative complications and management,follow-up,and subsequent treatment,and has reached a consensus after repeated discussions and revisions.Compared with the 2021 consensus,the main updates in the 2024 consensus include the following aspects:in the anatomy and classification section,the anatomical classification of high and low,single and multiple cysts of the presacral space has been added;in the surgical concept section,it is emphasized to protect the sacral nerves for presacral cysts with sacral variations;in the surgical approach section for excision,the surgical approach for different anatomical types of presacral cysts has been further clarified.For patients with preoperative enterocutaneous fistula,the use of gluteus maximus muscle flap t

关 键 词：骶前囊肿 直肠后肿物 盆腔 骶前间隙 共识 

分 类 号：R73[医药卫生—肿瘤]