膜解剖理论在腹腔镜中低位直肠癌术中的研究进展

Research progress of membrane anatomy theory in laparoscopic surgery for middle-low rectal cancer

目的了解膜解剖理论在腹腔镜中低位直肠癌手术中的进展与争议。方法对近年来膜解剖理论相关文献进行查阅复习并加以综述。结果膜解剖理论不仅提升了全直肠系膜切除术(total mesorectal excision,TME)的效果,确保了直肠系膜的完整性,更加规范了直肠癌手术操作和原则,也为术者提供了开阔的视野和清晰的解剖层次。膜解剖理论对肿瘤根治、器官切除、功能保护等有着重要的临床意义。然而关于此理论尚未达成统一意见,膜平面的建立和手术层面的选择仍需探讨研究。结论目前国内学者仍把膜解剖理论作为腹腔镜治疗中低位直肠癌的理论支持和参考依据,未来也可为外科医师提供新的研究方向和带来新的治疗前景,以延长直肠癌患者的生存预期和改善患者的生活质量。

Objective To investigate the progress and controversy of membrane anatomy theory in laparoscopic surgery for mid-low rectal cancer.Method The literature related to membrane anatomy theory in recent years was reviewed and summarized.Results The membrane anatomy theory not only improved the effect of total mesorectal excision,ensured the integrity of the mesorectum,more standardized the operation and principles of rectal cancer surgery,but also provided the operator with a broad vision and clear anatomical hierarchy.The theory of membrane anatomy had important clinical significance for tumor radical resection,organ resection and functional protection.However,this theory had not been unified,and the establishment of membrane plane and the choice of surgical plane were still needed to be studied and explored.Conclusion At present,scholars at home still regard the theory of membrane anatomy as the theoretical support and reference basis for the endoscopic treatment of mid-low rectal cancer,which can provide surgeons with new treatment prospects and research direction,and improve the survival expectancy and quality of life of patients with intestinal cancer in the future.