低位直肠癌保功能手术的解剖学基础

Anatomic basis of function-preserving operation for low rectal cancer

尽管全直肠系膜切除术（TME）是直肠癌根治术的金标准．但术后有一定的泌尿生殖功能障碍发生率。我们通过盆腔筋膜的解削研究明确了TME正确的手术层次，并进一步界定了手术层次与盆腔神经的关系．以期减少术巾神经损伤。值得注意的是，盆丛存在两种形态。如果盆丛为弥散状，完整的切除直肠系膜将不可避免地损伤盆丛，因而需通过深入的研究明确盆丛不同的功能单位。

Total mesorectal excision （TME） is being established as the gold standard for rectal cancer surgery, however sexual and urinary dysfunction is an established risk after TME. By cadaver dissections, we clarify the correct surgical plane for TME and further determine the relation between the surgical plane and pelvic autonomic nerves. It must be noted that the pelvic plexus can be divided into 2 categories： aggregated shape and diffused shape. The latter is in tight contact with visceral fascia, which seems to be inseparable from each other by sharp dissection. Therefore, it is necessary to study the function of different units in pelvic plexus.