经肛全直肠系膜切除术在低位直肠癌中的应用进展

Progress on the application of transanal total mesorectal excision in low rectal cancer

经肛全直肠系膜切除术包括完全切除和腹腔镜辅助经肛全直肠系膜切除术两种手术方式,可以经腔镜辅助、通过人体自然腔道自下而上进行全直肠系膜切除。随着经肛全直肠系膜切除术在低位直肠癌中应用越来越广泛,关于对该术式优势与争议的讨论逐渐增多,本文在经肛全直肠系膜切除术发展历程的基础上,对其手术要点与解剖标志、临床效果、应用范围、争议问题进行综述,以期为该术式的后续应用提供一定的参考。

Transanal total mesorectal excision(taTME)encompasses two surgical approaches:pure taTME and laparoscopic-assisted taTME.These techniques enable the complete excision of the total mesorectal envelope from bottom to top,aided by laparoscopy and through the body's natural orifices.As taTME becomes increasingly utilized in low rectal cancer surgery,discussions regarding its advantages and controversies have intensified.Based on the developmental trajectory of taTME,this article reviews its surgical essentials and anatomical landmarks,clinical outcomes,the scope of application,and controversial issues,aiming to provide a reference for the subsequent application of this surgical modality.