齿线上环直肠一周的绒毛状腺瘤的外科诊治附五例分析

Surgical treatment strategy of full circular rectal villous adenoma upon dentate line: report of 5 cases

目的探讨齿线上环直肠一周的绒毛状腺瘤的手术策略。方法回顾分析上海市长海医院治疗的5例齿线上环直肠一周的绒毛状腺瘤的病例,其中,3例患者采用经肛局部切除,2例患者采用直肠拖出式经腹前切除+末端回肠造口术方式治疗。结果 5例患者术后均恢复顺利,术后肛门功能良好,无围手术期死亡。结论对齿线上环直肠一周的直肠绒毛状腺瘤患者,是肛肠外科医生面临的棘手问题,应根据患者不同情况,采用经肛局部切除或采用直肠拖出式经腹前切除+末端回肠造口术,可达到理想的治疗效果。

Objective To explore the surgical approaches of full circular rectal villous adenoma upon dentate line. Methods Five patients with full circular rectal villous adenoma upon dentate line operated in our hospital were retrospectively studied, they were treated by transanal operation or rectal pull through operation with ileostomy. Results The patients recovered well. The anal function was satisfactory after the treatment. There was no perioperative mortality. Conclusion As villous adenoma is a kind of benign tumor;colorectal surgeon should formulate the surgical approach base on individual condition. Both of approaches have satisfactory effect for full circular rectal villous adenoma upon dentate line.