内镜切割吻合器在直肠肿瘤经肛门切除术中的应用

Application of Endo-GIA in the transanal excision of rectal neoplasms

目的探讨内镜切割吻合器在早期中低位直肠肿瘤经肛门局部切除术中的临床应用价值。方法回顾性分析2010至2015年收治的83例早期中低位直肠肿瘤患者的临床资料,根据经肛门局部切除手术方式的不同,分为内镜切割吻合器组(n=40)和传统组(n=43)。术后标本行常规免疫组化病理检测,同时对比两组患者的各种临床病理特征。结果两组患者肿瘤大小、病理类型、切缘距离、术后住院天数、局部并发症发生率比较无统计学差异(P均>0.05);肿瘤距肛缘距离[(5.413±1.290)cm vs(4.663±1.143)cm]、术中出血量[(8.150±3.978)ml vs(14.977±6.375)ml]及手术时间[(33.625±8.469)min vs(45.349±10.768)min]比较有统计学差异(P均<0.01)。结论应用内镜切割吻合器行早期中低位直肠肿瘤经肛门切除与传统经肛门切除手术疗效相当,但操作更简便易行、出血少、手术时间短,具有一定优势。

Objective To explore the clinical value of Endo-GIA in the transanal local excision of early stage mid-low rectal neoplasms. Methods A retrospective analysis of 83 patients with early stage mid-low rectal neoplasms treated from2010 to 2015 was performed. The patients were divided into Endo-GIA group（n = 40） and traditional transanal excision group（control group,n = 43）. The postoperative specimens were detected by routine immunohistochemical staining,and the clinicopathological features were compared between two groups. Results There were no significant differences in the tumor size,pathologic types,incision margin,post-operation hospital stay and incidence of local complications between two groups（all P 0. 05）. There were statistical differences in the distance from tumor to anal edge[（5. 413 ± 1. 290） cm vs（4. 663± 1. 143） cm],intraoperative bleeding [（8. 150 ± 3. 978） ml vs（14. 977 ± 6. 375） ml]and operation time [（33. 625 ±8. 469） min vs（45. 349 ± 10. 768） min] between Endo-GIA group and traditional transanal excision group（all P 0. 01）.Conclusion The curative effect of Endo-GIA is comparable to that of traditional transanal excision in the treatment for early stage mid-low rectal neoplasms,but Endo-GIA is more simple and convenient with less bleeding and shorter operative time.