刘司轶 1 刘绍华 2*
1.赣南医科大学;2.萍乡市人民医院
摘要(Abstract):
经肛全直肠系膜切除术(taTME)作为中低位直肠癌治疗的微创外科新技术,凭借独特的经肛入路优势,在改善手术视野、降低切缘阳性率、提升保肛率等方面展现出显著潜力。本文围绕taTME的技术背景、术后肛门功能影响机制、患者长期生活质量结局及当前研究争议展开系统综述,梳理该术式在肛门括约肌保护、生理功能恢复及社会心理适应等方面的研究进展,分析影响患者预后的关键因素,并指出当前研究的局限性与未来发展方向,为临床实践与后续研究提供参考。
关键词(KeyWords):
经肛全直肠系膜切除术;直肠癌;肛门功能;生活质量
参考文献(References):
[1]张大朝,陈远光,胡明,等.腹腔镜辅助经肛全直肠系膜切除术治疗直肠癌的长期疗效观察[J].中华胃肠外科杂志, 2019,22(3):262-266.
[2]尤俊,王廷豪,陈东汉,等.经肛全直肠系膜切除术的膜解剖特点与盆腔自主神经保护策略[J].中华胃肠外科杂志,2021,24(7):593-598.
[3] Yang, Wei-Feng,Chen, Wenbin,He, Zijian, et al.Simple transanal total mesorectal resection versus laparoscopic transabdominal total mesorectal resection for the treatment of low rectal cancer: a single-center retrospective case-control study [J].FRONTIERS IN SURGERY,2023,10.
[4]Lin, Yueh-Chen,Kuo, Ya-Ting,You, Jeng-Fu, et al.Transanal Total Mesorectal Excision ( TaTME ) versus Laparoscopic Total Mesorectal Excision for Lower Rectal Cancer: A Propensity Score-Matched Analysis [J].CANCERS , 2022, 14 (17):4098-4098. [5]Xu,Fengming,Zhang,Yiqiao,Yan,Jiafu,et al.The te a xT p M erE ien lc e e arn i in ng Ch cu in ra ve[ fo J r] m .i W d-O loR w LD rec J t O al U cR aN ncA eL r: O aF sin S g U l R e-G c IeC nA teL r ONCOLOGY,2022,20(1):1-13.
[6] Jouppe, P-O,Courtot, L.,Sindayigaya, R., et al.Trans-anal total mesorectal excision in low rectal cancers: Preliminary oncological results of a comparative study[J].Journal of Visceral Surgery,2022,159(1):13-20.
[7]Tirelli,F.,Lorenzon,L.,Biondi,A.,et al.Functional outcomes after transanal total mesorectal excision (TaTME): a random forest analysis to predict patients' outcomes[J].Techniques in Coloproctology,2023,27(11):1037-1046.
[8]Feng Lu,Shu-Guang Tan,Juan Zuo,et al.Comparative efficacy analysis of laparoscopic-assisted transanal total mesorectal excision vs laparoscopic transanal mesorectal excision for low-lying rectal cancer[J].World Journal of Gastrointestinal Surgery,2025, 17(1):147-155.
[9]Gloor, Severin,Pozza, Gioia,Troller, Rebekka, et al.Surgical Outcomes,Long-Term Recurrence Rate,and Resource U Tr ta iln iz sa a tn ia o ln T in ota a l P M ro e s sp ore e c c ti tv a e l E C x o ch io s r i ton of fo1 r65 Di P sa ta ti lenR tsecT ta r leaC te ad ncb e y r [J].CANCERS,2023,15(4):1190-1190
[10]Gardner,Ivy H.,Kelley, Katherine A.,Abdelmoaty, W ad a v la an a ceF d ., recte a t l a c la .nT c re a rns in an a alco tm ot p al lem x e s su o r rg e ic c a ta l l p e o xp cu i lsa i to in on[ ou J t ] c .oSm u e rg s ic fo a r l Endoscopy,2022,36(1):167-175.
[11]Gang, Du Yong,Dong, Lin,DeChun, Zhang, et a to l.t A al systematic review and meta-analysis of minimally invasive mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer [J].FRONTIERS IN ONCOLOGY,2023,13.
[12]李梦,任明扬,徐庆,等.腹腔镜直肠癌经肛全直肠系膜切除术学习曲线的多中心研究[J].中华消化外科杂志,2021, 20(3):306-314.