传统上,已使用2种用于溃疡性结肠炎直肠切除术的手术技术:全直肠系膜切除术(TME),并关闭直肠夹层(CRD)。最近,我们的研究小组提出了近TME技术的标准化,这结合了两种方法的优点。它降低了盆腔自主神经损伤的风险,并减少了直肠系膜残余的体积。执行Near-TME时,男性和女性的解剖标志不同,尤其是在前外侧偏侧。本文的目的是根据插图和腹腔镜治疗的真实病例,使用女性骨盆的特征性手术解剖标志来标准化女性的Near-TME技术(FemaleNear-TME)。该技术应由具有炎症性肠病手术经验和广泛的手术解剖学知识的外科医生进行。
Traditionally, 2 surgical techniques for proctectomy in ulcerative colitis have been used: total mesorectal excision (TME), and close rectal dissection (CRD). Recently, our research group has proposed the standardization of the Near-TME technique, which unites the advantages of both methods. It decreases the risk of pelvic autonomic nerve injury and reduces the volume of mesorectal remnant. When performing the Near-TME, the anatomical landmarks differ between men and women, especially in the anterolateral hemicircumference. The objective of this paper is to standardize the Near-TME technique in women (Female Near-TME) using characteristic surgical-anatomic landmarks of the female pelvis based on illustrations and a real case treated laparoscopically. This technique should be carried out by surgeons with experience in inflammatory bowel disease surgery and extensive knowledge of surgical anatomy.