Stewart David B, Dietz David W
Division of Surgery, Washington University School of Medicine, Barnes-Jewish-Christian Hospital, St. Louis, MO 63110, USA.
Clin Colon Rectal Surg. 2007 Aug;20(3):190-202. doi: 10.1055/s-2007-984863.
The introduction of total mesorectal excision (TME) for rectal cancer has reduced local recurrence rates and improved oncologic outcomes, although complication rates such as anastomotic leak have also been a consequence. With the advent of neoadjuvant therapy for rectal cancer, many are questioning how this development may change the role of TME. This review presents a history of how TME evolved and a description of this technique. Complication rates, the impact of neoadjuvant therapy on local recurrence, variations of TME such as nerve-sparing proctectomy and cancer-specific mesorectal excision, and a review of functional outcomes for various methods of reconstruction are presented.
直肠癌全直肠系膜切除术（TME）的引入降低了局部复发率并改善了肿瘤学结局，尽管诸如吻合口漏等并发症发生率也是其带来的后果。随着直肠癌新辅助治疗的出现，许多人质疑这一进展可能如何改变TME的作用。本文综述介绍了TME的发展历程以及该技术的描述。文中还阐述了并发症发生率、新辅助治疗对局部复发的影响、TME的变体（如保留神经的直肠切除术和癌症特异性直肠系膜切除术），以及对各种重建方法功能结局的综述。
