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3D腹腔镜下直肠癌根治术中植物神经保护的研究 预览

Study of autonomic nerve preservation in 3D laparoscopic radical resection for rectal cancer
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摘要 随着腹腔镜技术的迅速发展,腹腔镜全直肠系膜切除术(TME)已成为直肠癌的标准手术。然而,低、中位直肠癌患者术后膀胱功能及性功能障碍的发生率仍较高。如何避免盆腔自主神经损伤尤为重要。与传统的二维腹腔镜手术相比,三维腹腔镜手术还原了真实的三维视野、出现了纵深感,能更清晰地显示直肠周围层,减少盆腔自主神经损伤。近两年来本中心开展了3D腹腔镜下TME手术千余例。本文将探讨三维腹腔镜手术中自主神经保护的经验和技巧,包括盆腔自主神经解剖、手术方法的选择和手术中的要点。 With the rapid development of laparoscopic technology, laparoscopic total mesorectal excision(TME) has become the standard operation for rectal cancer. However, the incidence of bladder function and sexual dysfunction is still high in patients with low and middle rectal cancer after operation. How to avoid pelvic autonomic nerve injury is particularly important. Compared with traditional 2D laparoscopic surgery, 3D laparoscopy restores the real three-dimensional visual ?eld and presents a sense of depth, and so it can reveal the perirectal layers more clearly and then reduce pelvic autonomic nerve injury. In the past two years, our center has performed more than 1 000 cases of 3D laparoscopic TME surgery. This article will discuss the experience and skills of autonomic nerve preservation in 3D laparoscopic surgery, including pelvic autonomic nerve anatomy, selection of operation methods and key points during operation.
作者 杜涛 傅传刚 Du Tao;Fu Chuangang(Department of Colorectal Surgery, The Affiliated Shanghai East Hospital, Tongji University, Shanghai 200120, China)
出处 《中华结直肠疾病电子杂志》 2019年第4期349-352,共4页 Chinese Journal of Colorectal Disease(Electronic Edition)
基金 上海市浦东新区卫生系统重点专科建设项目(No.PWZZK2017-26)。
关键词 直肠肿瘤 3D腹腔镜 盆腔自主神经保护 Rectal neoplasms 3D laparoscopy Pelvic autonomic nerve preservation
作者简介 通信作者:傅传刚,教授,博士,博士生导师,主任医师,同济大学附属东方医院普外科主任、胃肠肛肠外科主任。现任美国结直肠外科医师协会荣誉委员,俄罗斯结直肠外科医师协会荣誉委员,中国医师协会外科分会肛肠外科医师委员会主任委员,海峡两岸医药卫生交流协会消化道外科专委会主任委员,国家结直肠肿瘤质控专家委员会常委。美国《Disease of Colon& Rectum》、意大利《Techniques in Coloproctology》编委,《中华结直肠疾病电子杂志》《结直肠肛门外科》杂志副主编,《中华外科杂志》《中华胃肠外科杂志》《中华普通外科杂志》等编委。发表中英文论文160 余篇,主编主译参编专著10 部。获军队科技成果二等奖三项,三等奖三项。获国家自然科学基金4 项,上海市科委大肠癌治疗重大攻关基金1 项,解放军“十一五”大肠癌治疗重点攻关基金1 项。应邀在美国、日本、巴西、俄罗斯等结直肠国际会议演讲10 余次。擅长结直肠癌诊断、根治手术、3D 腹腔镜微创手术以及综合治疗,尤其在低位直肠癌的保肛手术方面卓有建树。Email:Fugang416@126.com.
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