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经肛门全直肠系膜切除术的研究进展与未来发展前景

[Research progress and future development prospect of transanal total mesorectal excision].

作者信息

Luo S L, Kang L

机构信息

Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2021 Aug 25;24(8):672-677. doi: 10.3760/cma.j.cn441530-20210320-00125.

Abstract

Transanal total mesorectal excision (taTME) is one of the hotspots in colorectal surgery in recent years. Although most studies confirm that taTME is safe and feasible, some studies still showed that the morbidity of complication and local recurrence rate of taTME were higher than traditional laparoscopic surgery. This article reviews and analyzes the short-term and long-term outcomes of taTME and the related progress of postoperative function. The results showed that there were no significant differences in the main short-term and long-term efficacy between taTME and traditional laparoscopic TME, but taTME had potential advantages in postoperative functional recovery. The results of case study after passing the learning curve suggested that taTME had better short-term and long-term efficacy. Moreover, with the maturity of taTME technology, transanal endoscopic surgery has gradually shown its advantages in the treatment of complex pelvic diseases. In the future, the application of single-port robot will further promote the development of natural orifice transluminal endoscopic colorectal surgery.

摘要

经肛门全直肠系膜切除术(taTME)是近年来结直肠手术的热点之一。尽管大多数研究证实taTME是安全可行的,但一些研究仍表明,taTME的并发症发生率和局部复发率高于传统腹腔镜手术。本文回顾分析了taTME的短期和长期疗效以及术后功能的相关进展。结果显示,taTME与传统腹腔镜全直肠系膜切除术(TME)在主要短期和长期疗效方面无显著差异,但taTME在术后功能恢复方面具有潜在优势。通过学习曲线后的病例研究结果表明,taTME具有较好的短期和长期疗效。此外,随着taTME技术的成熟,经肛门内镜手术在复杂盆腔疾病的治疗中逐渐显示出优势。未来,单孔机器人的应用将进一步推动经自然腔道内镜下结直肠手术的发展。

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