关键词: 全直肠系膜切除, Denonvilliers筋膜, 手术层面, 排尿功能障碍, 性功能障碍

Abstract:

Controversy and expectation on preservation or excision of Denonvilliers fascia during radical rectal cancer resection        FANG Jia-feng，WEI Hong-bo. Department of Gastrointestinal Surgery，the Third Affiliated Hospital of Sun Yat-sen University，Guangzhou 510630，China
Corresponding author：WEI Hong-bo，E-mail: drweihb@126.com
Abstract    Total mesorectal excision (TME) is the golden standard of surgery for mid-low rectal cancer. Traditional TME surgery requires dissection in front of the Denonvilliers’ fascia，as well as excision of Denonvilliers’ fascia. However，the high incidence of postoperative urogenital dysfunction has led to worldwide controversy and query on TME surgery. Individualized treatment should be applied to patients with middle and low rectal cancer. For patients whose tumors are not located in the anterior and lateral walls of rectum or local stages are early，TME should be performed at the back of Denonvilliers fascia to preserve the integrity of Denonvilliers fascia as far as possible，so as to protect the pelvic autonomic nerve，avoid postoperative urination and sexual dysfunction，improve postoperative life quality of patients.

Key words: total mesorectal excision, Denonvilliers fascia, surgical plane, urological dysfunction, sexual dysfunction