经肛全直肠系膜切除术在低位直肠癌保肛治疗中的价值再审视OA

Transanal total mesorectal excision(taTME)offers a novel approach for sphincter preservation in low rectal cancer.By employing a reverse"down-to-up"operative trajectory;this technique significantly enhances visualization of deep pelvic anatomy;enabling sphincter preservation in select patients with challenging"difficult pelvis"conditions where traditional laparoscopic surgery may be inadequate.Chinese scholars have made systematic contributions to this field;spanning technology introduction;standardized promotion;international collaborative research;and leadership in the world's first phase Ⅲ randomized controlled trial comparing taTME with laparoscopic TME(the TaLaR study).The publication of these findings in the Journal of the American Medical Association(JAMA)marks China's transition from a"technology follower"to a"rule-setter"in this domain.This article systematically reviews the anatomical basis;technical evolution;key clinical evidence;complication prevention and management;learning curve;functional preservation;and future directions of taTME;aiming to provide references for clinical practice.