经肛腔镜技术体系的建立与拓展

Establishment and expansion of transanal endoscopic surgery system

低位直肠疾病的手术治疗已逐步从开腹扩大根治性手术转变为腔镜微创手术。经肛全直肠系膜切除术(taTME)采用腔镜技术与经肛入路结合,很好地解决了低位直肠癌手术中显露困难的问题,已成为低位直肠癌手术的新选择。进一步地,我们把在腔镜技术的基础上,经肛管直肠这个自然腔道进行病灶切除的这一技术,命名为经肛腔镜手术。它属于经自然腔道手术(NOTES)理念的范畴,与传统术式相比,在达到相同治疗目的的同时,具备创伤更小、更可能保全相应器官功能的优势,是各种低位直肠手术演变的方向与趋势。

The surgical treatment of low rectal diseases has gradually changed from open radical operation to endoscopic minimally invasive operation. Transanal total mesorectal excision (taTME) combines endoscopic technique with transanal approach, and solves the problem of surgery exposure in lower rectal cancer. It has become an option for colorectal surgeons in lower rectal cancer. We named this operation as transanal endoscopic surgery, for the appropriateness when it is applied for other colorectal diseases. Transanal endoscopic surgery belongs to the category of natural orifice transluminal endoscopic surgery, which achieves the same pathological outcomes with less invasiveness and better organ functions compared with traditional surgery. It represents the tendency of low rectal surgery.