外翻拖出式经括约肌间切除在直肠恶性肿瘤超低位保肛中的应用  

Application of intersphincteric resection by transanal specimen eversion and extraction with ultra-low anal preservation for rectal malignant tumors

作　　者：王五艺 郑阳春[1,2] 易波 郭奇[2] 芮元祎 陈超 冯晓沛 Wang Wuyi;Zheng Yanghun;Guo Qi;Rui Yuanyi;Chen Chao;Feng Xiaopei(Department of Colorectal Surgery,Sichuan Cancer Hospital,Chengdu 610041,China;Chengdu Medical College,Chengdu 610041,China)

机构地区：[1]四川省肿瘤医院大肠外科,成都610041 [2]成都医学院,四川610500

出　　处：《中华腔镜外科杂志（电子版）》2023年第3期186-189,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：四川省科技厅创新团队资助课题(2017TD0029)。

摘　　要：目的:探讨外翻拖出式经括约肌间切除在直肠恶性肿瘤超低位保肛中的应用。方法:回顾性分析2022年5月至12月四川省肿瘤医院大肠外科收治的3例直肠恶性肿瘤行外翻拖出式经括约肌间切除患者的临床资料,总结经肛切除手术技巧,探讨近期临床效果。结果:3例患者均成功完成手术,平均手术时间337 min,平均术中失血40 ml,其中,肿瘤外翻后经肛切除平均耗时5 min,平均出血5 ml。所有患者术后均顺利恢复,术后10 d顺利出院。随访至今,肛门括约功能良好。结论:外翻拖出式经括约肌间切除有助于实现超低位精准保肛,可降低经肛切除操作难度,缩短手术时间,利于临床推广,是低位直肠恶性肿瘤保肛手术的新选择。Objective:To investigate the value of intersphincteric resection by transanal specimen eversion and extraction with ultra-low anal preservation in surgical treatment of rectal malignant tumors.Methods:From May to December 2022,the clinical data of 3 cases with rectal malignant tumors treated in the Department of Colorectal Surgery of Sichuan Cancer Hospital who underwent intersphincteric resection(ISR)by transanal specimen eversion and extraction were retrospectively analyzed.The technical aspects of transanal resection were summarized and the value of the technique was discussed.Results:All three patients were successfully operated,with an average operation time of 337 minutes and an average blood loss of 40 ml;Among them,the average time for transanal resection was 5 minutes and the blood loss was 5 ml after the rectum was reversed and pulled out.All patients recovered smoothly after surgery and were discharged 10 days after operation.Following up to date,their anal sphincter functions has been acceptable.Conclusion:The technique of intersphincteric resection by transanal specimen eversion and extraction facilitates the anus preservation,reduces the difficulty of transanal resection,shortens the operation time,and is conducive to clinical promotion.It could serve as a new alternative to anus preservation for surgical treatment of lower rectal malignant tumors.

关 键 词：低位直肠癌 外翻拖出 经括约肌间切除 超低位保肛 

分 类 号：R735.37[医药卫生—肿瘤]