中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (03): 243-245.

• 论著 • 上一篇    下一篇

经肛门内镜手术治疗结直肠肿瘤可行性研究

尹 路，林谋斌，华智丽，倪金迪，陈伟国，黄 梁，张浩波，倪俊声   

  1. 上海交通大学医学院附属瑞金医院外科，上海 200025
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-03-13 发布日期:2009-03-13

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-03-13 Published:2009-03-13

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摘要：

目的 评估经肛门内镜显微手术治疗结直肠肿瘤的临床应用可行性，探讨手术中操作困难的处理策略。方法 回顾性分析上海交通大学医学院附属瑞金医院外科2006年9月至2008年6月期间36例经肛门内镜显微手术病人的临床资料。结果 36例病人均成功完成经肛门内镜显微手术，无中转开腹病例。平均手术时间为71（20~200）min。术后病理：腺瘤22例，腺癌8例，类癌5例，炎性肿块1例。术后平均住院时间为4.7（3~9）d。并发症方面：1例术后有肛门内出血，1例术后有暂时性排便失禁感。1例术后5个月发现直肠肿瘤复发。结论 经肛门内镜显微手术是一种对直肠中、上段及乙状结肠下段肿瘤有效、安全、可行性强的微创切除手术。严格选择病例，注意临床处理策略，经肛门内镜显微手术可取得和传统手术相仿甚至更优的结果，且住院时间短，并发症少，有良好的临床应用前景。

关键词: 直肠肿瘤, 经肛门内镜显微手术

Abstract:

Study of clinical strategy of transanal endoscopic microsurgery in patients with colon or rectal tumor YIN Lu， LIN Mou-bin, HUA Zhi-li, et al.Department of Surgery，RuiJin Hospital，Medical school of shanghai Jiaotong University, Shanghai200025, China. Corresponding author: YIN Lu，Email:yindalu@yahoo.com.cn Abstract Objective To evaluate the feasibility of transanal endoscopic microsurgery and discuss the possible difficulties during the operation. Methods The data of 36 patients undergoing transanal endoscopic microsurgery during the period September 2006 to June 2008 in Ruijin hospital were reviewed. Results Transanal endoscopic microsurgery was successfully performed in all the patients. There was no procedure converted to laparotomy. The average operative time was 71(20~200) min. The histologic diagnosis indicated 1 inflammatory mass, 22 adenomas, 5 carcinoids, 8 carcinomas. The average hospital stay after transanal endoscopic microsurgery was 4.7(3~9) days. There was no operation-related mortality. Complications included rectal bleeding (n=1),flatus incontinence (n=1). There was one local recurrence which was found in the 5 month. Conclusion Transanal endoscopic microsurgery is an effective, safe and minimally invasive surgical technique leading to a short hospital stay and less complications. Therefore, transanal endoscopic microsurgery can achieve similar or better consequence than traditional surgery.

Key words: transanal endoscopic microsurgery, rectal tumor