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近年来,经肛门全直肠系膜切除(TaTME)手术不断发展但又颇具争议。TaTME手术尝试在保证肿瘤根治的基础上进一步实现微创、美观效果的统一,甚至体现经自然腔道内镜外科手术(NOTES)的理念,代表了当前直肠癌手术的最新动向和发展趋势。然而,很多学者认为TaTME会增加直肠癌手术的难度和手术风险,甚至残留了部分远端直肠的系膜,从而导致病人术后局部复发风险的增加。因此,当前如何规范TaTME手术的适应证以及手术操作流程,是我国结直肠外科面临的热点和难点问题之一。此外,如何有序组织TaTME手术相关的临床研究,获得TaTME手术相关的高级别循证医学证据,也是相对紧迫的任务之一。
In recent years, transanal mesorectal excision (TaTME) surgery continues to develop but controversial. TaTME surgery attempts to further achieve the goal of minimally invasive and aesthetic effects on the basis of tumor radicalization and even embodies the concept of natural intraoral endoscopic surgery (NOTES), which represents the latest trend and development trend of current rectal cancer surgery. However, many scholars believe that TaTME will increase the difficulty and surgical risk of rectal cancer surgery, and may even leave part of the mesorectum of the distal rectum, resulting in an increased risk of local recurrence. Therefore, how to standardize the indications of TaTME surgery and surgical procedures, is one of the hot and difficult issues facing colorectal surgery in our country. In addition, it is also a relatively urgent task to organize the TaTME surgery-related clinical studies in an orderly manner and to obtain evidence-based high-level evidence-based medicine related to TaTME surgery.