目的探讨全直肠系膜切除术(TME)的合理实施及临床应用。方法回顾性分析2008年11月至2009年6月年以来164例全直肠系膜切除术的直肠癌患者的临床资料。结果 164例中无手术死亡病例,Miles术23例,141例保肛,141例吻合器吻合,保肛成功率86.9%(141/164),术后吻合口瘘2例,1急诊行结肠造瘘术,1例1个月后改行Miles术。无骶前大出血病例,术后近期排尿困难1例,近期大便失禁1例。术后16个月复发1例来院行再手术切除。结论全直肠系膜切除术(TME)的合理实施可使手术病死率、术中大出血发生率降低,复发率降低,可有效保存盆腔脏器功能。 Objective To investigate the reasonable implementation and clinical application of total mesorectal excision (TME). Methods The clinical data of 164 patients with rectal cancer undergoing total mesorectal excision from November 2008 to June 2009 were retrospectively analyzed. Results There were no surgical deaths in 164 cases. Miles was performed in 23 cases, 141 cases of anus preservation and 141 cases of anastomosis. The success rate of anus preservation was 86.9% (141/164), 2 cases of anastomotic fistula, 1 case of colonic Fistula surgery, 1 patient changed to Miles operation after 1 month. No sacral hemorrhage cases, 1 case of recent dysuria, incontinence in 1 case. One patient recurred 16 months after surgery to be surgically removed. Conclusion The implementation of total mesorectal excision (TME) can make the operation mortality, the incidence of intraoperative hemorrhage decreased, the recurrence rate decreased, which can effectively preserve the function of pelvic organs.