Total mesorectal excision (TME) represents the gold standard for radical resection in rectal cancer. The development in radiology and laparoscopic surgical equipment and the advancement in technology have led to a deepened understanding of the mesorectum and its surrounding structures. Both the accuracy of preoperative staging and the preciseness of the planes of TME surgical dissection have been enhanced. The postoperative local recurrence rate is reduced and the long-term survival of rectal cancer patients is improved. The preservation of the pelvic autonomic nervous system maintains the patient's urinary and sexual functions to the greatest extent possible, which in turn improves the patient's postoperative quality of life. A thorough understanding of the anatomy of the mesorectum and its surrounding structures is a prerequisite for successful TME. Herein, we review the basic concepts and the anatomy of the mesorectum in the current literature. Some important clinical issues are also discussed systematically in terms of imaging, surgery, and pathology.
全直肠系膜切除（TME）是直肠癌根治术的"金标准"。近年来，随着影像及腹腔镜外科器械设备和技术的进步，人们对直肠系膜及周围结构的认识逐步加深，术前分期更加准确，TME手术平面更加精准，明显降低了患者术后的局部复发率，改善了远期生存。同时，自主神经系统得到比较完好的保留，最大程度地保护了患者的排尿和性功能，改善了患者术后的生活质量。正确认识直肠系膜及盆腔的解剖结构，是成功施行TME手术治疗的前提。因此，本文结合既往文献，对直肠系膜的基本概念及解剖结构进行了深入探讨，并从影像、外科及病理多学科角度，对临床相关重要问题进行了系统阐述。.
Keywords: Magnetic resonance imaging; Mesorectum; Pathology; Total mesorectal excision.