中国实用外科杂志2026，Vol.46Issue(2)：268-272,5.DOI:10.19538/j.cjps.issn1005-2208.2026.02.19
经肛全直肠系膜切除解剖学基础与临床应用研究进展
Research advances in anatomical basis and clinical application of transanal total mesorectal excision
摘要
Abstract
Transanal total mesorectal excision(taTME)is a reverse anatomical approach developed to overcome the limitations of the traditional transabdominal approach,such as difficult surgical exposure and challenges in controlling the distal resection margin in patients with a narrow pelvis,obesity,or low rectal cancer.The core of taTME lies in the accurate identification and maintenance of the"holy plane"between the rectal visceral fascia and the prehypogastric nerve fascia from a transanal perspective.Key anatomical points include the recognition and management of structures such as the rectosacral fascia in the posterior plane,the pelvic plexus neurovascular bundle in the lateral plane,and Denonvilliers' fascia along with the rectourethralis muscle in the anterior plane.TaTME also demonstrates unique anatomical advantages in complex procedures such as lateral lymph node dissection and multivisceral resection,enhancing the precision and safety of deep pelvic surgery.However,the technique is associated with a steep learning curve and requires further standardization and individualized research to optimize surgical outcomes and functional preservation.关键词
经肛全直肠系膜切除/直肠癌/解剖学基础/盆腔筋膜Key words
transanal total mesorectal excision/rectal cancer/anatomical basis/pelvic fascia分类
医药卫生引用本文复制引用
赵世栋,申占龙..经肛全直肠系膜切除解剖学基础与临床应用研究进展[J].中国实用外科杂志,2026,46(2):268-272,5.基金项目
国家自然科学基金项目(No.U24A20737) National Natural Science Foundation of China(No.U24A20737) （No.U24A20737）
