腹腔镜外科杂志2017，Vol.22Issue(10)：753-756,4.DOI:10.13499/j.cnki.fqjwkzz.2017.10.753
经肛门内镜微创手术治疗直肠占位的临床体会 (附53例报告)
Application of transanal endoscopic microsurgery in 53 patients with rectal neoplasms
摘要
Abstract
Objective:To investigate the effect of transanal endoscopic microsurgery ( TEM) in the treatment of rectal lesions . Methods:Clinical data of 53 patients with rectal lesions treated by TEM between Feb .2013 and Dec.2016 were collected and the effect of TEM in treating rectal lesions was analyzed .Results:All 53 patients were performed TEM successfully .Surgical procedures included the full-thickness excision (49 cases) and submucosal and partial muscular excision (4 cases).The average operation time was (42.8 ±14.3) min (range 20-100 min).The mean operative blood loss was (8.2 ±4.4) ml (range 5-45 ml).Perforation into the peritoneal cavity occurred in two cases with upper middle anterior wall tumors while full thickness excision was done by TEM ,and closed immedi-ately via laparoscopic suturing without developing peritonitis or pelvic infection .There were no perioperative deaths .Postoperative com-plications were identified in 4 cases (7.5%),including 1 case of postoperative hemorrhage ,1 case of urinary retention,1 case of pul-monary infection ,and 1 case of rectal wound infection ,and cured through conservative treatment .The average hospital stay after the pro-cedure was (4.5 ±2.6) d (range,1-13 d).The mean follow-up time was (23.4 ±7.3) months (range,5-52 months).None of the 53 patients were found any recurrence or metastasis .And no control or defecation dysfunction was found during the follow-up.Conclu-sions:TEM is a safe and effective procedure .It is superior to traditional transanal local excision in both minimally invasive effect and curative effect .TEM is now considered as the first choice for rectal local excision .关键词
直肠疾病/经肛门/内窥镜检查/外科手术,微创性Key words
Rectal diseases/Transanal/Endoscopy/Surgical procedures,minimally invasive分类
医药卫生引用本文复制引用
封益飞,傅赞,孙跃明,王诗佳,张悦,吉冰,钱文伟,季东健,张冬生,胥子玮,王勇..经肛门内镜微创手术治疗直肠占位的临床体会 (附53例报告)[J].腹腔镜外科杂志,2017,22(10):753-756,4.基金项目
教育部基金项目(编号:2012YQ030261) （编号:2012YQ030261）
江苏省科技厅基础研究计划项目(编号:BK20131448) （编号:BK20131448）
