经肛门内镜显微手术的应用现状与进展  

Transanal endoscopic microsurgery: Current application and future prospects

作　　者：韩曲 胡谦[1] 廖勃[1] 欧阳柳生 胡小云[1] 

机构地区：[1]南昌大学第二附属医院胃肠外科,江西省南昌市330006

出　　处：《世界华人消化杂志》2014年第29期4445-4450,共6页World Chinese Journal of Digestology

摘　　要：直肠肿瘤严重危害人类健康,由于肛管在解剖学上承载着控制粪便的特殊功能,使得直肠肿瘤在手术方式的选择上受到了极大的限制.直径<3 cm的良性肿瘤可以通过经肛门路径或软镜直接切除,然而直径较大或宽基底易癌变易复发的肿瘤仍需通过传统的开腹手术来切除.经肛门内镜显微手术(transanal endoscopic microsurgery,TEM)就是为了解决这一问题而设计的,其特殊的器械能完整切除距肛门4-25 cm的肿瘤,获得理想切缘,降低并发症发生率.因其微创理念、节约手术时间、并发症少等优点,TEM在直肠息肉、直肠腺瘤治疗方面有较广泛的应用,但对早期和进展期直肠癌的治疗仍有一定争议,本文分析总结了TEM的应用研究现状,重点对其适应症、临床效果、未来发展等进行了综述.Rectal neoplasms pose serious harm to human health. The options of surgical procedure for these patients have been limited because of the special features of anal and rectal anatomy and physiology. Tumors with a diameter less than 3 cm can be resected through the anus or soft microscope; however, those with a large diameter and wide base which are cancerous and relapse easily still need conventional laparotomy procedures. Transanal endoscopic microsurgery（TEM） was designed to avoid laparotomy for these patients. Using special instruments, TEM allows to totally resect tumors located 4-25 cm from the anus with safe margin and lower rate of complications. Because of minimal invasiveness, shorter operative time and lower rate of complications, TEM can be widely applied in rectal polyps and adenomas. Currently, thereand advanced rectal cancer. This paper review the current situation of application and research o TEM, with emphasis put on its indications, clinica efficiency and future development.

关 键 词：经肛门内镜显微手术 直肠肿瘤 进展 

分 类 号：R657.1[医药卫生—外科学]