目的 探讨经肛门内镜显微手术(TEM)治疗直肠肿瘤的疗效。方法 回顾性分析2009年1~12月期间我院行TEM治疗7例直肠腺瘤患者的临床资料。结果 7例直肠肿瘤均获完整切除,切缘均阴性。手术时间55~240 min,平均110 min; 术中出血量5~100 ml,平均45 ml。术后病理诊断: 直肠绒毛状腺瘤4例,绒毛管状腺瘤2例,直肠腺癌1例。手术并发症: 术中直肠穿孔1例,肺部感染1例,尿潴留1例。 7例随访6~13个月,平均8个月,肿瘤无复发。结论 TEM治疗直肠肿瘤安全、有效。
Objective To summarize the research progress of transanal endoscopic microsurgery in the treatment of rectal tumors. Method The literatures on transanal endoscopic treatment of rectal tumors was collected and reviewed. ResultsTransanal endoscopic microsurgery was one of the local resection methods. It was a minimally invasive surgery combining laparoscopy and endoscopy. Transanal endoscopic microsurgery equipment was mainly composed of special rectal mirror lens and high-pressure pneumoperitoneum machine. After full-thickness resection of the lesion, the defect was sutured under endoscopy, so as to avoid serious postoperative complications caused by radical surgery. Transanal endoscopic microsurgery was suitable for T1 stage rectal cancer with benign lesions such as rectal adenoma and rectal polyps and no lymph node metastasis. There was still some controversy about the treatment of higher-grade rectal cancer. Neoadjuvant radiotherapy and chemotherapy combined with transanal endoscopic microsurgery is being actively carried out in the treatment of rectal cancer. Conclusions Transanal endoscopic microsurgery is a safe and effective method for some rectal tumors. It has the characteristics of low perioperative complication rate, fast postoperative recovery and low recurrence rate.