关键词: 直肠癌, 腹腔镜, 全直肠系膜切除, 经肛门全直肠系膜切除, 经自然孔道内镜外科手术

Abstract:

Pure transanal total mesorectal excision: the future development direction of laparoscopic rectal cancer surgery?        ZHANG Zhong-tao.Department of General Surgery, Beijing Friendship Hospital, Capital Medical University；National Clinical Research Center or Digestive Diseases, Beijing100050,China
Abstract    Total mesorectal excision (TME) significantly improved the prognosis and effect of surgical treatment of rectal cancer. With the emergence and popularization of laparoscopic technique, the laparoscopic TME has been gaining acceptance rapidly and widely. With the gradual accumulation of medical evidence for more than 20 years, although the laparoscopic TME shows some advantages in minimally invasive effect, the postoperative serious complications and postoperative hospitalization time did not show a significant advantage. Therefore, combined with many kinds of technology including natural orifice transluminal endoscopic surgery, the transanal endoscopic microsurgery and the single incision laparoscopic surgery, the transanal total mesorectal excision (taTME) has become a new focus. Further proposed, the pure transanal total mesorectal excision (pure taTME) is a large collection of minimally invasive surgical techniques for rectal cancer.The trend of surgical treatment for rectal cancer is toward less invasive surgical techniques which should maintain the principles of oncologic resection obtained with TME.

Key words: rectal cancer;laparoscopy, total mesorectal excision, transanal total mesorectal excision, natural orificetransluminal endoscopic surgery