符智勇 任明扬

    [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，由于舐曲的影响，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。

    [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[中图分类号]R735.3+7? [文献标识码]A? [文章编号]2095-0616(2022)02-0050-05

    Advances in the study of digestive tract reconstruction by transanal total mesorectal excision

    FU Zhiyong? REN Mingyang

    Department of Gastrointestinal Surgery，the Affiliated Nanchong Central Hospital of North Sichuan Medical College，Sichuan，Nanchong 637000，China

    [Abstract] 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 ......