摘要直肠侧方结构一直是人们关注的焦点，目前通用的称谓是直肠"侧韧带"。对其进行深入的认识，有助于更好地完成全直肠系膜切除手术，并保护患者的泌尿生殖系统功能及控制排粪功能。目前围绕直肠侧方结构的争论点主要集中在：（1）直肠"侧韧带"是否存在。（2）直肠侧方结构的组成是什么，直肠中动脉是否存在。目前解剖上对直肠侧方结构的研究并未达成共识，但临床手术中发现，直肠"侧韧带"确实存在，并且是直肠癌发生侧方淋巴结转移的途径。直肠"侧韧带"内包含直肠中动脉、神经分支、淋巴管以及包裹的脂肪纤维组织。笔者总结临床经验认为，直肠中动脉在"侧韧带"中恒定出现，只是部分动脉血管直径较小，难以被观察到。从解剖学、胚胎学和外科手术的角度考虑，笔者建议，将直肠"侧韧带"这一与直肠系膜相通、并包含多种组织的结构称为直肠"侧系膜"可能更为合适，这也更加符合直肠癌发生侧方转移的解剖基础。本文结合既往文献和本团队临床经验，提出这一新命名供大家讨论。

abstractsColorectal surgeons have focused on the lateral structure of rectum for a long time and lateral ligament is the common term to depict this structure. A better understanding of lateral rectal structure could be beneficial to performing the total mesorectum excision (TME) procedure and protecting patients' urinary, sexual and defecation function. The main controversies focus on two aspects: (1) Does the lateral ligament exist? (2) What dose it contain? Does the middle rectal artery exist? Up to now, anatomic studies have failed to reach consensus on the lateral rectal structure. However, surgeons do find the lateral rectal ligament during surgery and it may be the pathway for lateral lymph node metastasis in rectal cancer. The lateral rectal structure contains the middle rectal artery, nerve branches, lymphatics and adipose fibrous tissue around them. We summarize our clinical experience and conclude that the middle rectal artery appears in lateral ligament constantly but some of them are too small to be easily observed. Therefore, regarding the perspective of membrane anatomy, embryology and surgery, this structure may be more appropriate to be called the "lateral mesorectum". We propose this new term based on the previous literature and our own experience for the readers' reference.