完全经肛门全直肠系膜切除术的临床分析(附16例报告)  

Clinical analysis of pure transanal total mesorectal excision for rectal neoplasms: with a report of 16 cases

作　　者：于刚[1] 王效明 荣震 耿瑞超 荣若增 王松[1] 耿小峰[1] YU Gang;WANG Xi- ao-ming;RONG Zhen(Department of Colorectal Cancer, Linzi District People＇s Hospital of Zibo City, Zibo 255400, Chin)

机构地区：[1]淄博市临淄区人民医院,山东淄博255400

出　　处：《腹腔镜外科杂志》2018年第3期175-179,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨完全经肛门全直肠系膜切除术治疗直肠癌的可行性及安全性。方法:回顾分析2015年12月至2016年12月完全经肛门行全直肠系膜切除术16例患者的临床资料。患者45~71岁,平均(62.3±8.0)岁,体重指数19.0~28.7 kg/m^2,平均(24.6±2.8)kg/m^2。结果:16例均顺利完成手术,无一例中转腹腔镜辅助或开腹手术。手术时间95~300 min,平均(154.7±65.0)min;术中出血量20~60 ml,平均(32.5±13.4)ml;术后排气时间24~48 h,平均(30.6±9.4)h;下床活动时间12~36 h,平均(19.5±7.4)h;术后住院8~13 d,平均(9.8±1.6)d。术后无腹腔感染、出血及吻合口瘘等并发症发生。结论:对于合适的直肠癌患者,完全经肛门全直肠系膜切除术是安全、可行的。Objective： To explore the feasibility and safety of pure transanal total mesorectal excision（ pTaTME） in the treatment of rectal cancer. Methods： The clinical data of 16 patients who underwent p Ta TME between Dec. 2015 and Dec. 2016 were retrospectively analyzed. The average age was 62. 3 ± 8. 0（ range,45-71） and the average BMI was（ 24. 6 ± 2. 8） kg/m^2（ range,19. 0-28. 7 kg/m^2）. Results： All the 16 patients successfully underwent p Ta TME operation without laparoscopic-assisted surgery or laparotomy. The operation times was 95-300 min,with the average of（ 154. 7 ± 65. 0） min. The blood loss during operation was 20-60 ml with the average of（ 32. 5 ± 13. 4） ml. The postoperative first exhaust time was 24-48 h with the average of（ 30. 6 ± 9. 4） h. The first ambulation time was 12-36 h with the average of（ 19. 5 ± 7. 4） h. The postoperative hospital stay was 8-13 d with the average of（ 9. 8 ±1. 6） d. All the patients recovered uneventfully without postoperative abdominal infection,hemorrhage,anastomotic fistula or other serious complications. Conclusions： For suitable patients of rectal neoplasms,pTaTME is safe and feasible.

关 键 词：直肠肿瘤 全直肠系膜切除术 经肛门 

分 类 号：R735.37[医药卫生—肿瘤]