The theory of membrane surgery actually holds the same concepts as that of traditional cancer surgery, which believes that tumor spread is regarded as an isotropic process but the tumor is confined by the block of the membrane. Therefore, the radical resection can be achieved by complete mesentery excision along the membrane plane. The surgical practice derived from these conceptions is extended excision and lays emphasis on tumor-free margins. But the theory is controversial in the view of the existence of mesorectal fascial envelope and the feasibility of complete excision of mesorectum along the "holy plane". Based on ontogenetic anatomy, the compartment theory suggeststhat tumor spread is not isotropic, and it is locally confined within the ontogenetic compartment derived from a common primordium for a relatively long phase during their natural course. Local tumor is suppressed by the boundary instead of fascia. The anatomical territory developing from each anlage primordium may be separated morphologically. Consequently, ontogenetic compartment theory states that optimal local control of cancer is achieved by whole compartment resection, irrespective of margin width. The compartment model of tumor spread provides explanations for total mesorectal excision (TME) which excises the complete rectum compartment including the rectum and its surrounding vascular and ligamentous mesenteries. The compartment theory may set up the new principles for surgical tumor treatment, namely the resection of the tumor bearing compartment rather than target organ.
膜解剖在本质上还是传统肿瘤外科的思维，认为肿瘤细胞的转移是没有方向的，但是由于膜的存在导致系膜封闭，使得肿瘤细胞局限，因而通过膜平面可以达到完整系膜切除而根治肿瘤。实质上还是强调肿瘤的扩大切除，注重切缘的安全距离。但是这个理论在解剖学上存在争议，主要在于系膜"信封"是否存在和"神圣平面"能否达到完整系膜切除。基于发生解剖学的"腔室"理论认为，肿瘤细胞的转移并不是无序、没有方向的，而是在相当长的一段时间内滞留于同一胚胎起源（原基）的"腔室"内，是边界的抑制效应而非筋膜的阻挡使得肿瘤细胞局限。由于同一原基形成的胚胎源性整体在形态上可能是分离的，因而，强调"腔室"的完整切除而并不关注切缘。全直肠系膜切除的根本机制在于直肠腔室包括直肠及其系膜的完整切除。腔室理论的提出将有可能改变肿瘤外科的手术原则，即以腔室而非器官为中心进行手术。.
Keywords: Compartment; Membrane anatomy; Rectal neoplasms; Total mesorectal excision.