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腹腔镜直肠癌低位前切除术
引用本文:邓海军,沈智勇,朱煜.腹腔镜直肠癌低位前切除术[J].中华普外科手术学杂志(电子版),2019,13(1):17-17.
作者姓名:邓海军  沈智勇  朱煜
作者单位:1. 510515 广东省广州市南方医科大学南方医院普通外科
摘    要:腹腔镜直肠癌低位前切除术已在临床上受到广泛认可。术中手术层面的识别与游离、盆腔自主神经的保护对于手术成功与否以及患者术后生活质量尤为重要。腹腔镜直肠癌低位前切除术中需注意:(1)直肠系膜与神经前筋膜之间游离;(2)紧贴直肠系膜游离间隙;(3)保证直肠系膜后方、两侧方和前方的完整;(4)TME手术直肠系膜终止线位于肛门直肠环,游离应到位,不能残留直肠系膜。实践证实,基于膜解剖的直肠癌全系膜切除有助于盆腔自主神经保护以及实现肿瘤的根治性切除。

关 键 词:直肠肿瘤  肠系膜  腹腔镜检查  自主神经系统  

Laparoscopic anterior resection for low rectal cance
Authors:Haijun Deng  Zhiyong Shen  Yu Zhu
Institution:1. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China, 510515
Abstract:Laparoscopic anterior resection has been widely verified in clinical practice for low rectal cancer. Recognition and separation of the surgical fascia are crucial for the protection of pelvic autonomic nerves with better postoperative quality of life for patients. Notes of laparoscopic anterior resection for low rectal cancer are as following: (1)Proper separation of rectal fascia and prehypogastric nerve fasia; (2)Sharp separation along with rectal posterior fascia; (3)Keep the completeness of rectal circumferential fascia; (4)Sufficient separation of rectal fascia to anorectal ring plane without residual mesorectum. It is proved that total mesorectal excision of rectal cancer based on the anatomy of the fascia is beneficial for protection of pelvic autonomic nerves and radical resection of tumor.
Keywords:Rectal neoplasms  Mesentery  Laparoscopy  Autonomic nervous system  
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