中国实用外科杂志

中国实用外科杂志

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完全经肛门全直肠系膜切除8例报告

杨盈赤，金    岚，张忠涛   

  1. 国家消化系统疾病临床医学研究中心  首都医科大学附属北京友谊医院普外科，北京100050
  • 出版日期:2015-08-01 发布日期:2015-07-27

  • Online:2015-08-01 Published:2015-07-27

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摘要：

目的    探讨完全经肛门全直肠系膜切除的手术操作可行性及围手术期安全性。方法    自2015年5-7月，首都医科大学附属北京友谊医院普外科行完全经肛门全直肠系膜切除治疗中低位直肠癌8例。回顾性分析8例病人临床资料。结果    8例病人均顺利完成完全经肛门全直肠系膜切除，无中转腹腔镜辅助或开放手术病例。术后标本质量包括系膜完整程度、切除肠管长度（15~29 cm）、下切缘距离（1.5~3.0 cm），均符合全直肠系膜切除要求。病人术后平均住院天数为4.8（3~7）d。1例术后发生尿潴留。平均手术时间219（160~300）min。结论    完全经肛门全直肠系膜切除是中低位直肠癌外科治疗的新方向，但远期效果还需更多病例及循证医学证据来验证。

关键词: 直肠癌, 腹腔镜, 全直肠系膜切除：经肛门全直肠系膜切除, 经自然孔道内镜外科手术

Abstract:

Pure transanal total mesorectal excision:A report of 8 cases        YANG Ying-chi, JIN Lan, ZHANG Zhong-tao. Department of General Surgery, Beijing Friendship Hospital, Capital Medical University；National Clinical Research Center for Digestive Diseases,Beijing100050,China
Correspondence author：ZHANG Zhong-tao. E-mail: zhangzht@medmail.com.cn
Abstract    Objective    Discussed feasibility and perioperative safety of pure transanal TME.  Methods    8 patients with mid-or low rectal tumors were selected to undergo pure transanal TME using the SILS port platform in Department of General Surgery, Beijing Friendship Hospital from May to July, 2015. Perioperative clinical data  and histological parameters were reviewed and analyzed. Results    8 patients were successfully completed pure transanal TME. No case was laparoscopic assisted operation and laparotomy. The quality of specimens, including the specimen length (15~29 cm) and the distal margin (1.5~3.0 cm), are satisfied. The average length of hospital stay was 4.8 days (3~7 days). One case occurred postoperation uroschesis. The average operative duration was 219 minutes (160~300 minutes). Conclusion    pure transanal TME is a new direction in the surgical treatment of distal rectal cancer. But larger, randomized controlled trials with longterm follow-up are warranted.

Key words: rectal cancer, laparoscopy；total mesorectal excision, transanal total mesorectal excision , natural orifice transluminal endoscopic surgery