TaTME-直肠癌手术的新突破.pptxVIP

经肛全直肠系膜切除术（Transanal total mesorectal excision TaTME）;腹腔镜TME手术的肿瘤根治效果（腹腔镜手术3 年局部复发率、无病存活率、总存活率）与开放手术相似。 Bonjer HJ, Deijen CL, Abis GA. A randomized trial of laparoscopic laparoscopicvesus open surgery for rectal cancer［J］. N Engl J Med,2015,372(14):1324-1332.;;Current status of trans-anal total mesorectal excision(TaTME) following the Second International Consensus Conference published in Colorectal Disease think: The challenge of operating in the deep pelvis is confirmed by results of a recent randomized controlled trial showing a 10% positive circumferential radial margin rate in laparoscopic and open TME and in particular a concerning 22% positive circumferential radial margin rate in the lower rectum in the open arm of the trial [1]. Furthermore, the need for multiple firings of linear stapling devices in low rectal division has been associated with an increase in the surgical morbidity of the procedure [2]. 1 van der Pas MHGM, Haglind E, Cuesta MA, Furst A, Lacy AM, Hop WCJ. Bonjer HJ Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised,phase 3 trial. Lancet Oncol 2013; 14: 210–8. 2 Ito M, Sugito M, Kobayashi A, Nishizawa Y, Tsunoda Y,Saito N. Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resection. Int J Colorectal Dis 2008; 23: 703–7.;;Tatme适应证; TaTME操作平台经肛门微创手术（ＴＡMＩＳ）平台商品化的经肛门单孔通道和经肛门内镜显微手术（ＴＥM）平台的直肠镜; TEM与TAMIS平台的比较; TaTME手术步骤;TATME与腹腔镜辅助TME比较; Heald认为tatme的最大优势之一是解决了既往TME术中对中下段直肠系膜周围间隙暴露不佳而造成的盆腔神经副损伤。 Heald RJ. A new solution to some old problems: transanal TME［J］. Tech Coloproctol，2013，17(3):257-258.;Transanal TATA/TME: a case-matched study of taTME versus laparoscopic TME surgery for rectal cancer;Transanal TATA/TME: a case-matched study of taTME versus laparoscopic TME surgery for rectal cancer;Transanal TATA/TME: a case-matched study