自制经肛单孔多通道装置在经肛门微创手术治疗低位直肠神经内分泌肿瘤中的应用  

Application of self-made transanal single-port multi-channel device in transanal minimally invasive surgery for low rectal neuroendocrine tumors

作　　者：陈超 刘天舟[1] 李金秋[1] 刘晶晶[1] 唐小欢 刘远达 朱甲明[1] CHEN Chao;LIU Tian-zhou;LI Jin-qiu(Department of Gastrointestinal Nutrition and Hernia Surgery,the Second Hospital of Jilin University,Changchun 130041,China)

机构地区：[1]吉林大学第二医院,吉林长春130041

出　　处：《腹腔镜外科杂志》2019年第3期201-203,207,共4页Journal of Laparoscopic Surgery

基　　金：吉林省科技发展计划项目(20180101169JC);吉林省卫生计生青年科技骨干培养计划项目(2016Q023)

摘　　要：目的:评价经肛门微创手术中应用自制经肛单孔多通道装置治疗直肠神经内分泌肿瘤的临床价值。方法:回顾分析2016年7月至2017年12月收治的5例行直肠神经内分泌肿瘤局部切除患者的临床资料。结果:5例患者均顺利完成手术,术中术野稳定、清晰,无漏气、意外发生,术后病理报告示切缘(包括环周及垂直)阴性。中位手术时间55(40～75) min,中位失血量38(22～105) mL,术后中位住院时间5(4～7) d。术后1例患者发热,经对症治疗后治愈;未出现肛门括约肌功能异常。术后随访12个月,无局部复发病例,无排便困难、直肠狭窄发生。结论:自制经肛单孔多通道装置安全、可行,经济实惠,取材方便;此平台还可用于直肠良性肿瘤、T_1期直肠癌的治疗,虽然存在一定的技术不足,但仍具有一定的临床应用前景。Objective:To explore the application value of the self-made transanal single-port multi-channel device in transanal minimally invasive surgery(TAMIS)for low rectal neuroendocrine tumors.Methods:Retrospective analysis was made on the clinical data of 5 patients who suffered from rectal neuroendocrine tumors and underwent local resection of rectal tumors from Jul.2016 to Dec.2017.Results:All 5 patients successfully underwent the operation.The operative field was stable and clear,no leakage and no accident occurred.Postoperative pathological reports indicated that the incision margin was negative.The median operative time was 55(40-75)min,the median intraoperative blood loss was 38(22-105)mL,the median postoperative hospital stay was 5(4-7)d.The complication was 1 case of fever after operation,which was cured after symptomatic treatment.No anorectal sphincter dysfunction was found in any patients.The local recurrence rate was 0%after 12 months of operation,and no difficult defecation or rectostenosis occurred.Conclusions:The self-made transanal single-port device is safe,feasible,economical and convenient to obtain materials.With the help of TAMIS platform,it can also be used for resection of rectal benign tumors and early T1 rectal cancer.Although there are some technical shortcomings,this procedure still has certain clinical application prospects.

关 键 词：直肠神经内分泌肿瘤 自制经肛单孔多通道装置 经肛门微创手术 

分 类 号：R735.37[医药卫生—肿瘤]