Treatment of rectal villous adenoma and early rectal carcinoma by transanal endoscopic microsurgery:Report of 31 cases
- VernacularTitle:经肛门内镜显微手术治疗直肠绒毛状腺瘤和早期直肠癌31例
- Author:
Jiaxing MENG
;
Guole LIN
;
Yingyu LIU
;
Weijin YE
;
- Publication Type:Journal Article
- Keywords:
Rectoscope;
Microsurgery;
Rectal tumor
- From:
Chinese Journal of Minimally Invasive Surgery
2001;0(01):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate outcomes of transanal endoscopic microsurgery(TEM) for the treatment of rectal villous adenoma and early-stage rectal carcinoma.Methods A series of 31 patients with rectal tumors underwent TEM from November 1995 to December 2003.The operation was performed under general anesthesia.The patients were placed in a dependent position dictated by the location of the tumor.A special rectoscope was inserted into the anus with CO_2 insufflation to keep the rectum open.Under the stereoscope and laparoscopic-type instruments,the tumor was completely resected(submucosal or full-thickness excision) using a needle diathermy or a 5-mm ultrasonic dissector.The operative wound was closed with intra-lumen continuous sutures.Results The rectal tumor was completely removed with negative resection margins in all the 31 patients.The operating time was 45~220 min(mean,95 min) and the intraoperative blood loss was 0~180 ml(mean,40 ml).Complications included temporary flatus incontinence in 2 patients,acute retention of urine in 1 patient,exacerbation of chronic obstructive airway disease in 1,and secondary hemorrhage following Aspirin taking in 1.The postoperative pathological stages were pT_0 in 16 patients,pT_(is) in 2 patients,pT_1 in 7,pT_2 in 3,and pT_3 in 3.Follow-up checkups in the 31 patients for 2~92 months(mean,23 months) revealed no local recurrence.Conclusions TEM is a safe and effective minimally invasive surgical technique for the treatment of rectal villous adenoma and early rectal carcinoma.
