摘要
目的探讨经肛门内镜显微手术(TEM)直肠全层切除治疗直肠神经内分泌肿瘤的效果。方法回顾性分析北京协和医院2006年12月至2015年12月间74例采用TEM治疗的直肠神经内分泌肿瘤患者。收集患者的一般资料、肿瘤特点、手术情况、术后病理及随访结果。结果其中50例患者行原发病灶切除,24例患者因结肠镜下切除后标本切缘不清或阳性行二次手术。肿瘤直径平均(1.02±0.43)cm,距离肛缘(7.9±1.7)cm。平均手术时间(58.7±12.1)min,平均术中出血量(13.1±5.0)ml。所有标本基底和侧切缘均阴性。平均随访3.6年,无肿瘤复发。结论 TEM可以作为直径较小的中上段直肠神经内分泌肿瘤手术治疗的首选。
Objective To assess the efficacy of full-thickness excision using transanal endoscopic microsurgery （TEM） in the treatment of rectal neuroendocrine tumors. Methods We analyzed the data of seventy four rectal neuroendocrine tumor patients who underwent TEM between Dec. 2006 and Dec. 2015 at our department. Data collected included patient demographics, tumor characteristics, operative details, postoperative outcomes, pathologic findings, and follow-ups. Results TEM was performed as a primary excision （ n = 50） or as complete surgery after incomplete resection by endoscopic polypectomy （ n = 24 ）. The mean size of the primary tumor was （ 1.02 ± 0.43） cm, and the mean distance of the tumor from the anal verge was （7.9 ± 1.7） cm. The mean duration of the operation was （58.7 ± 12.1 ） min, and the mean blood loss was （13.1 ± 5.0）ml. Histopathologically, all tumors showed typical histology, and both deep and lateralsurgical margins were completely free of tumors. No recurrence was noted during the median of 3.6 years＇ follow-up. Conclusions Full-thickness excision using TEM could be a first surgical option for complete removal of middle-upper small rectal neuroendocrine tumors.
出处
《中华腔镜外科杂志（电子版）》
2016年第4期200-203,共4页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
关键词
经肛门内镜显微手术
直肠神经内分泌肿瘤
全层切除
Transanal endoscopic microsurgery
Rectal neuroendocrine tumor
Full- thickness excision
