经肛门内镜微创手术与腹腔镜手术治疗低位直肠间质瘤的临床效果对比分析  

Low Rectal Stromal Tumor Treated with Transanal Endoscopic Microsurgery and with Laparoscopic Surgery:Comparative Analysis on their Clinical Effects

作　　者：王凯 WANG Kai(Dept,of Mini-invasive Surgery,the Second People's Hopsital of Nanyang City Hanyang,Henan 473000)

机构地区：[1]河南省南阳市第二人民医院微创外科,河南南阳473000

出　　处：《中国肛肠病杂志》2022年第2期11-13,共3页Chinese Journal of Coloproctology

摘　　要：目的:比较经肛门内镜微创手术(TEM)与腹腔镜手术治疗低位直肠间质瘤的临床效果。方法:回顾2018年1月至2020年2月我院收治的82例低位直肠间质瘤患者临床资料,其中接受TEM治疗42例(TEM组),腹腔镜手术治疗40例(腹腔镜组)。比较2组手术情况、术后恢复情况和随访情况,以及手术前后不同时间肛门测压结果。结果:2组82例患者肿瘤均被完整切除,切缘均为阴性。TEM组术中出血量明显少于腹腔镜组,手术时间、术后肛门排气时间、住院时间均明显短于腹腔镜组,P<0.05。2组术后并发症及复发情况方面无明显差异,P>0.05。2组患者术前肛门静息压(ARP)、肛管最大收缩压(MSP)、直肠感知阈值(RVST)和直肠最大耐受量(MTV)比较差异均无统计学意义(P>0.05);术后1个月2组ARP、MSP、RVST和MTV均下降(P<0.05),然后逐渐回升;术后6个月时,TEM组ARP、MSP、RVST和MTV基本恢复至术前水平(P>0.05),腹腔镜组ARP、MSP恢复至术前水平(P>0.05),而MTV和RVST仍低于术前水平(P<0.05)。结论:TEM与腹腔镜手术治疗低位直肠间质瘤均安全可行,但TEM术中出血更少,手术时间更短,术后恢复更快。Objective To compare the clinical effects of transanal endoscopic microsurgery(TEM),or of laparoscopic surgery tumor(LST)in the treatment of low rectal stromal tumor(LRST).Methods Reviewed the clinical data of 82LRST patients treated in author’s hospital(2018-01-2020-02),including TEM group(treated with TEM,in 42cases),and LS group(40cases treated with LS),and compared the status on both groups’operation,postoperative recovery,and follow-up,as well as anal pressure status at different time-points before and after surgery.Results The neoplasms of all patients of both groups were completely resected,and resection margin was all negative;in intraoperative bleeding volume,and in the time for operation,for postoperative flatus from anus,and for hospitalization,TEM group was respectively less;and shorter than LS group(all,P<0.05).In postoperative status on complication and recurrence there was no significant difference between the two groups(P>0.05).In ARP,anal MSP,RVST and rectum MTV,there was no statistical difference between the two groups(P>0.05),but,1month after surgery both groups’ARP,MSP,RVST and MTV were declined(P<0.05),afterwards,also gradually up,till 6months after surgery,basically returned to preoperative levels(P>0.05),but,in LS group,only ARP and MSP to preoperative levels(P>0.05),meanwhile,MTV and RVST still lower than preoperative levels(P<0.05).Conclusion Both procedures for LRST are all safe and feasible,but TEM is of less intraoperative bleeding volume,of shorter operating time,and faster postoperative recovery.

关 键 词：低位直肠间质瘤 经肛门内镜微创手术 腹腔镜手术 疗效 

分 类 号：R735.37[医药卫生—肿瘤]