摘要
直肠癌是最常见的消化道恶性肿瘤之一,在世界范围内其发病率与病死率分别位于恶性肿瘤的第3位、第2位。全直肠系膜切除术(TME)至今仍是直肠癌手术治疗的金标准,但传统手术在进行盆底操作时,由于骶曲的影响,手术视野暴露常较为困难,容易损伤盆丛神经,造成患者术后排便功能障碍。经肛全直肠系膜切除术(taTME)则克服了这一难点,使其成为了近年来结直肠外科领域研究的热点,它使术者能够在直视下进行精准解剖,更有利保护盆腔神经丛,减少对患者排便功能的影响。消化道重建是直肠癌手术中的关键步骤,规范的消化道重建对于提高手术成功率、降低手术并发症发生率、促进患者术后康复、提高患者术后生命质量等具有重要意义。本文就taTME消化道重建及其术后肛门功能、术后并发症的研究现状进行综述。
Rectal cancer is one of the most common malignant tumors of the digestive tract,with its incidence and mortality rate ranking the 3rd and 2nd among malignant tumors worldwide,respectively.Total mesorectal excision(TME)is still the gold standard of surgical treatment for rectal cancer,but as a traditional surgical method,it is easy to damage the pelvic plexus at the pelvic floor and cause postoperative defecation dysfunction of patients due to the difficulty in revealing the surgical field resulted from the influence of sacral flexure.Fortunately,transanal total mesorectal excision(taTME)overcomes this difficulty and has become a research focus in colorectal surgery in recent years.It enables the surgical operator to perform precise dissection under direct vision,which will better protect the pelvic plexus,and reduce the impact of surgery on the postoperative defecation function of patients.Digestive tract reconstruction is a key step in rectal cancer surgery,and standardized digestive tract reconstruction is of great significance to improve the success rate of surgery,reduce the incidence of s urgical complications,and promote pos toperative recovery as well as improve the quality of life of patients after surgery.This paper reviews the current status of the study on digestive tract reconstruction by taTME and the postoperative anal function and postoperative com plications.
作者
符智勇
任明扬
FU Zhiyong;REN Mingyang(Department of Gastrointestinal Surgery,the Affiliated Nanchong Central Hospital of North Sichuan Medical College,Sichuan,Nanchong 637000,China)
出处
《中国医药科学》
2022年第2期50-53,80,共5页
China Medicine And Pharmacy
关键词
经肛全直肠系膜切除术
消化道重建
改良BACON术
肛门功能
术后并发症
综述
Transanal total mesorectal excision
Digestive tract reconstruction
Modified Bacon procedure
Anal function
Postoperative complications
review