完全经肛门全直肠系膜切除8例报告

Pure transanal total mesorectal excision:A report of 8 cases

目的探讨完全经肛门全直肠系膜切除的手术操作可行性及围手术期安全性。方法自2015年5-7月,首都医科大学附属北京友谊医院普外科行完全经肛门全直肠系膜切除治疗中低位直肠癌8例。回顾性分析8例病人临床资料。结果 8例病人均顺利完成完全经肛门全直肠系膜切除,无中转腹腔镜辅助或开放手术病例。术后标本质量包括系膜完整程度、切除肠管长度（15-29 cm）、下切缘距离（1.5-3.0 cm）,均符合全直肠系膜切除要求。病人术后平均住院天数为4.8（3-7）d。1例术后发生尿潴留。平均手术时间219（160-300）min。结论完全经肛门全直肠系膜切除是中低位直肠癌外科治疗的新方向,但远期效果还需更多病例及循证医学证据来验证。

Objective Discussed feasibility and perioperative safety of pure transanal TME. Methods 8 patients with mid-or low rectal tumors were selected to undergo pure transanal TME using the SILS port platform in Department of General Surgery, Beijing Friendship Hospital from May to July, 2015. Perioperative clinical data and histological parameters were reviewed and analyzed. Results 8 patients were successfully completed pure transanal TME. No case was laparoscopic assisted operation and laparotomy. The quality of specimens, including the specimen length （15-29 cm） and the distal margin （1.5-3.0 cm）, are satisfied. The average length of hospital stay was 4.8 days （3-7 days）. One case occurred postoperation uroschesis. The average operative duration was 219 minutes （160-300 minutes）. Conclusion pure transanal TME is a new direction in the surgical treatment of distal rectal cancer. But larger, randomized controlled trials with longterm follow-up are warranted.