Application value of multidisciplinary team model in normatively carrying out transanal total mesorectal excision

Q4 Medicine 中华消化外科杂志 Pub Date : 2020-01-20 DOI:10.3760/CMA.J.ISSN.1673-9752.2020.01.010

Zhanlong Shen, Y. Ye, M. Yin, Z. Gao, Jian Cao, Long Zhao

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Abstract

With certain advantages of superior surgical fields and better chances for anus reservation, transanal total mesorectal excision (TaTME) is a novel surgical approach for low rectal cancer. Guidelines recommend multidisciplinary team (MDT) work as a clinical routine for standardized treatment of rectal cancer. Indication of TaTME depends on multidisciplinary discussion including preoperative staging, prediction of recurrence risks. Standardized preoperative evaluation by MDT and decisions after MDT discussion are the guarantee for the stan-dardized implementation and reasonable promotion of TaTME. Meanwhile, as a procedure for improving local efficacy of rectal cancer, TaTME could save a part of patients with low rectal cancer the trouble of neoadjuvant chemoradiotherapy based on accurate staging by radiologists. That might upgrade status of colorectal surgeons in the MDT and contribute to optimize both curative effects and health economics. Key words: Rectal neoplasms; Transanal total mesorectal excision; Multidisciplinary team; Surgery; Standardization; Diagnosis; Treatment; Model

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多学科团队模式在规范实施经肛全肠系膜切除术中的应用价值

经肛直肠全肠系膜切除术(TaTME)具有手术视野优越、保留肛门机会大等优点，是低位直肠癌的一种新型手术方式。指南推荐多学科团队(MDT)工作作为标准化治疗直肠癌的临床常规。TaTME的适应症取决于多学科的讨论，包括术前分期，预测复发风险。标准化的MDT术前评估和MDT讨论后的决策是TaTME规范实施和合理推广的保障。同时，TaTME作为一种提高直肠癌局部疗效的手段，可以使部分低位直肠癌患者省去放射科医师根据准确分期进行新辅助放化疗的麻烦。这可能会提升结直肠外科医生在MDT中的地位，并有助于优化疗效和卫生经济学。关键词:直肠肿瘤;经肛门全肠系膜切除术;多学科团队;手术;标准化;诊断;治疗;模型

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