经肛门手术治疗直肠绒毛状腺瘤  

Transanal Procedure for Rectal Villous Adenoma

作　　者：孙宏斌[1] 曹永磊 解萧宇 周燕[1] 江从庆[1] 

机构地区：[1]武汉大学中南医院结直肠肛门外科,湖北武汉430071

出　　处：《医学新知》2016年第4期265-266,共2页New Medicine

摘　　要：目的：探讨经肛门手术治疗直肠绒毛状腺瘤的疗效。方法回顾性分析18例直肠绒毛状腺瘤经肛门手术的临床资料。结果18例患者术前病理活检证实为直肠绒毛状腺瘤，其中6例局部高级别上皮内瘤变，直肠腔内超声提示肿瘤未突破粘膜下层，盆腔 MRI 未发现直肠周围肿大淋巴结。18例患者均成功接受经肛门手术，无严重手术并发症。术后病理：17例患者组织学检查显示肿瘤完全切除，1例侧切缘有少量腺瘤残留；18例直肠绒毛状腺瘤中5例局部高级别上皮内瘤变，1例病变累及浅肌层（追加腹腔镜内括约肌切除术）。随访1~54个月，4例局部复发，复发时间为术后6个月至21个月，均再次行局部切除术。结论经肛门手术治疗直肠绒毛状腺瘤，操作简单，并发症少，复发率低。Objective To investigate the efficacy of transanal procedure for rectal villous adenoma. Methods The clinical data of 18 patients with rectal villous adenoma who underwent transanal procedure were analyzed. Results 18 patients were confirmed rectal villous adenoma through preoperative biopsy,including 6 patients with local high grade intraepithelial neoplasia,for which adenoma did not violate submucosa through transrectal ultrasonography and perirectal enlarged lymph nodes were not found by pelvic MRI. All the 18 patients underwent transanal procedure suc-cessfully without severe complications. Postoperative pathology indicated that adenoma in 17 patients was resected completely,small adenoma residual was found in 1 patient,5 cases with local high grade intraepithelial neoplasia and 1 case showed superficial muscular infiltration（additional laparoscopic intersphincteric resection）. 4 cases relapsed with local recurrence from 6 to 21 months after operation during 1 to 54 months follow - up,all of which underwent lo-cal resection. Conclusion Transanal procedure is simple with less complications and low recurrence rate for rectal villous adenoma.

关 键 词：直肠绒毛状腺瘤 经肛门手术 

分 类 号：R735.37[医药卫生—肿瘤]