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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

21卷

期数:

2015年04期

页码:

308-310

栏目:

临床医学

出版日期:

2015-07-15

文章信息/Info

Title:

Application of Endo-GIA in the treatment of middle/low rectal adenoma

文章编号:

1006-8147（2015）04-0308-03

作者:

胡冰辉 ; 曹际森 ; 韩洪秋 ; 刘 彤

(天津医科大学总医院普通外科,天津 300052)

Author(s):

HU Bing-hui; CAO Ji-sen; HAN Hong-qiu; LIU Tong

(Department of General Surgery, General Hospital, Tianjin Medical University Tianjin 300052,China)

关键词:

直肠腺瘤; 局部切除; 切割缝合器

Keywords:

rectal adenoma;  local excision;  Endo-GIA

分类号:

R657.1

DOI:

-

文献标志码:

A

摘要:

目的：探讨在中低位直肠腺瘤手术治疗中，使用腔镜切割缝合器（Endo-GIA）行经肛门直肠局部切除术和传统经肛门直肠局部切除术（TAE）的效果。方法：收集66例TAE和50例应用Endo-GIA经肛门直肠局部切除术的临床资料，就患者一般资料、手术疗效和病理检查结果进行分析。结果：两组手术患者的性别、年龄、肿瘤大小、术后住院时间和并发症发生率差异无统计学意义（p＞0.05）。切除肿瘤距肛缘距离Endo-GIA组[（5.30±1.46）cm]高于TAE组[（3.62±1.31）cm]（P＜0.01）；手术时间GIA组[（30.10±9.61）min]较TAE组[（47.50±13.05）min]缩短（P＜0.01）；中位出血量GIA组5 mL，较TAE组20 mL明显减少（P＜0.01）。结论：与传统经肛门局部切除术相比，应用腹腔镜切割缝合器经肛门局部切除中低位直肠腺瘤出血量少，切除范围广，操作省时简便。

Abstract:

Objective: To investigate the effect of trans-anal local excision by using endovascular gastrointestinal anastomosis stapler (Endo-GIA) in surgical treatment of middle/low rectal adenoma compared with conventional trans-anal local excision. Methods: The clinical data of 66 cases treated with conventional trans-anal local excision and 50 cases treated with trans-anal local excision by using Endo-GIA were retrospectively analyzed. Results: No significant difference was found in sex, age, tumor size, post-operation hospital stay and the complication rate between the two groups(P＞0.05). However, the distance from the anal verge of the Endo-GIA group[ (5.30±1.46)cm ]was significantly higher than the TAE group [(3.62±1.31)cm ](P <0.01). The operation time of GIA group [(30.10±9.61)min] was significantly shorter compared with TAE group [(47.50±13.05)min ](P <0.01). The median amount of bleeding of GIA group was 5 mL, significantly less than the TAE group, 20 mL (P <0.01). Conclusion: Compared with the conventional trans-anal local excision, the trans-anal excision of middle/low rectal adenoma by using Endo-GIA is a simple and time saving operation with wider excision range and much less bleeding.

参考文献/References:

[1]Muto T, Bussey H R, Morson B C. The evolution of cancer of the colon and rectum[J]. Cancer, 1975, 36(6): 2251

[2]蒙家兴，邵初晓，刘应裕，等．经肛门内镜显微手术切除直肠肿瘤[J]．中华胃肠外科杂志，2003，6（2）：96

[3]Maya A, Vorenberg A, Oviedo M, et al. Learning curve for transanal endoscopic microsurgery: a single-center experience[J]. Surg Endosc, 2014, 28(5): 1407

[4]陈云生，陈邑岐，潘良富．经肛门局部切除低位直肠肿瘤38例分析[J]．中国误诊学杂志，2011，11（12）：2961

[5]U. S.preventive services task force.screening for colorectal Cancer:U.S.preventive services task force recommendation statement[J]. Ann Intern Med, 2008, 149(9): 627

[6]Sharma A, Hartley J, Monson J R. Local excision of rectal tumors[J]. Surg Oncol, 2003, 12(1): 51

[7]Smart C J, Cunningham C, Bach S P. Transanal endoscopic microsurgery[J]. Best Pract Res Clin Gastroenterol, 2014, 28(1): 143

[8]Doornebosch P G, Gosselink M P, Neijenhuis P A, et al. Impact of transanal endoscopic microsurgery on functional outcome and quality of Life[J]. Int J Colorectal Dis, 2008, 23(7): 709

[9]宋轶欢，杨关根，裘建明，等．经肛门内镜显微手术对直肠肿瘤患者术后肛门功能和生活质量影响的评估[J]．中华胃肠外科杂志，2014，17（8）：809

[10]Allaix M E, Rebecchi F, Giaccone C, et al. Long-term functional results and quality of Life after transanal endoscopic microsurgery[J]. Br J Surg, 2011, 98(11): 1635

[11]何永刚，韩意，华智莉，等．经肛门内镜微创手术治疗32例直肠腺瘤[J]．中华胃肠外科杂志，2010，13（12）：910

[12]Heidary B, Phang T P, Raval M J, et al. Transanal endoscopic microsurgery: a review[J]. Can J Surg, 2014, 57(2): 127

[13]Amann M, Modabber A, Burghardt J, et al. Transanal endoscopic microsurgery in treatment of rectal adenomas and T1 low-risk carcinomas[J]. World J Surg Oncol, 2012, 10: 255

[14]吴国举，黄美雄，周新平，等．经肛门内镜微创手术治疗老年人结直肠腺瘤[J]．中华老年医学杂志，2011，30（10）：839

相似文献/References:

备注/Memo

备注/Memo:

作者简介 胡冰辉（1987-），男，硕士在读，普通外科学；

通信作者：刘彤，E-mail：liutonga@126.com。

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更新日期/Last Update: 2015-07-16