腹腔镜直肠癌全直肠系膜切除术中保护盆自主神经的手术技巧

Surgical techniques of pelvic autonomic nerves protection in laparoscopic total mesorectal excision for the treatment of rectal neoplasms

2011年，美国国家癌症综合网络（NCCN）直肠癌临床实践指南仍然将腹腔镜直肠癌根治术局限于临床研究，不提倡在临床工作中常规开展。一方面是因为与开放手术比较，腹腔镜直肠癌根治术的远期疗效尚未明确；另一方面是因为在腹腔镜下显露自主神经并加以保护相当困难，

Laparoscopic radical resection of rectal neo-plasms is still under clinical research currently due to the following 2 reasons. Firstly, compared with open surgery, the longterm efficacy of laparoscopic surgery remains unclear; secondly, the pelvic autonomic nerves are difficult to be exposed and easy to be damaged during the surgery under laparoscope. Till present time, our department has completed 800 cases of laparoscopic radical resection of colorectal neoplasms, in which rectal neo-plasms accounted for 70%. For most cases, the pelvic autonomic nerves have been exposed and protected properly. This paper summarized the skills to protect the pelvic autonomic nerves in the laparoscopic total mesorectal excision used for the treatment of rectal neoplasms.