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腹腔镜技术运用于结直肠手术20年,经过大量的科研和临床实践,已日趋完善。手术器械的改进和新能源系统的出现,大大改善了腹腔镜下结直肠癌手术的效果。我们就腹腔镜下结直肠癌诊治的进展做一综述。1相对成熟的理念1.1全直肠系膜切除术(total mesorectal excision,TME)概念的强化TME的概念是在1982年由healed等提出的关于改进直肠癌根治手术效果、降低复发率的理论。直肠系膜的概念是建立在盆腔局部解剖的基础之上:直肠周围脂肪与盆壁之间存在盆
Laparoscopic technique used in colorectal surgery for 20 years, after a large number of scientific research and clinical practice, has been increasingly improved. The improvement of surgical instruments and the appearance of new energy systems have greatly improved the effect of laparoscopic colorectal cancer surgery. We reviewed the progress of diagnosis and treatment of colorectal cancer under laparoscopy. 1 Relatively mature concept 1.1 The concept of total mesorectal excision (TME) enhancement The concept of TME was proposed by Healed et al in 1982 to improve the effect of radical surgery of rectal cancer and reduce the relapse rate. The concept of mesorectum is based on the anatomy of the pelvic floor on the basis of the presence of pelvic fossa around the pelvis