中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2012年
3期
203-206
,共4页
直肠肿瘤%结直肠外科手术%直肠镜检查%显微外科手术
直腸腫瘤%結直腸外科手術%直腸鏡檢查%顯微外科手術
직장종류%결직장외과수술%직장경검사%현미외과수술
Rectal neoplasms%Colorectal Surgery%Proctoscopy%Microsurgery
目的 比较经肛门内镜显微手术(TEM)和Mason手术在早期直肠癌切除术中的应用.方法 将早期直肠癌患者按就诊时间段分为2组.2000年1月至2006年3月就诊患者接受Mason手术(26例)；2006年4月至2011年7月就诊患者接受TEM手术(21例).Mason组患者和TEM组患者年龄、性别、术前TNM分期和瘤体直径差异无统计学意义,TEM组在肿瘤距肛缘的距离上高于Mason组.比较2组患者的手术安全性、术后并发症、术后恢复和肿瘤学疗效.结果 2组均无手术死亡病例.TEM组手术时间为(67±24) min,术中失血量(9±6) ml,显著少于Mason组[分别为( 102 ±40) min和(51±27) ml](t=3.526、7.078,P＜0.05).TEM组术后下床时间、尿管留置时间、进食时间和住院天数分别为(1.3±0.5)、(1.2±0.4)、(1.5±0.5)和(4.3±1.6)d,显著短于Mason组[分别为(2.5±0.6)、(5.4±1.3)、(5.6±1.2)和(12.1±7.1)d](t=4.925 ～ 14.640,P＜0.05).TEM组失访1例,平均随访时间36.5个月；Mason组平均随访时间81.6个月.2组3年无病生存率差异无统计学意义(TEM组:94.8％；Mason组:96.3％).结论 TEM技术用于早期直肠癌治疗具有良好的微创效果和理想的肿瘤学疗效.
目的 比較經肛門內鏡顯微手術(TEM)和Mason手術在早期直腸癌切除術中的應用.方法 將早期直腸癌患者按就診時間段分為2組.2000年1月至2006年3月就診患者接受Mason手術(26例)；2006年4月至2011年7月就診患者接受TEM手術(21例).Mason組患者和TEM組患者年齡、性彆、術前TNM分期和瘤體直徑差異無統計學意義,TEM組在腫瘤距肛緣的距離上高于Mason組.比較2組患者的手術安全性、術後併髮癥、術後恢複和腫瘤學療效.結果 2組均無手術死亡病例.TEM組手術時間為(67±24) min,術中失血量(9±6) ml,顯著少于Mason組[分彆為( 102 ±40) min和(51±27) ml](t=3.526、7.078,P＜0.05).TEM組術後下床時間、尿管留置時間、進食時間和住院天數分彆為(1.3±0.5)、(1.2±0.4)、(1.5±0.5)和(4.3±1.6)d,顯著短于Mason組[分彆為(2.5±0.6)、(5.4±1.3)、(5.6±1.2)和(12.1±7.1)d](t=4.925 ～ 14.640,P＜0.05).TEM組失訪1例,平均隨訪時間36.5箇月；Mason組平均隨訪時間81.6箇月.2組3年無病生存率差異無統計學意義(TEM組:94.8％；Mason組:96.3％).結論 TEM技術用于早期直腸癌治療具有良好的微創效果和理想的腫瘤學療效.
목적 비교경항문내경현미수술(TEM)화Mason수술재조기직장암절제술중적응용.방법 장조기직장암환자안취진시간단분위2조.2000년1월지2006년3월취진환자접수Mason수술(26례)；2006년4월지2011년7월취진환자접수TEM수술(21례).Mason조환자화TEM조환자년령、성별、술전TNM분기화류체직경차이무통계학의의,TEM조재종류거항연적거리상고우Mason조.비교2조환자적수술안전성、술후병발증、술후회복화종류학료효.결과 2조균무수술사망병례.TEM조수술시간위(67±24) min,술중실혈량(9±6) ml,현저소우Mason조[분별위( 102 ±40) min화(51±27) ml](t=3.526、7.078,P＜0.05).TEM조술후하상시간、뇨관류치시간、진식시간화주원천수분별위(1.3±0.5)、(1.2±0.4)、(1.5±0.5)화(4.3±1.6)d,현저단우Mason조[분별위(2.5±0.6)、(5.4±1.3)、(5.6±1.2)화(12.1±7.1)d](t=4.925 ～ 14.640,P＜0.05).TEM조실방1례,평균수방시간36.5개월；Mason조평균수방시간81.6개월.2조3년무병생존솔차이무통계학의의(TEM조:94.8％；Mason조:96.3％).결론 TEM기술용우조기직장암치료구유량호적미창효과화이상적종류학료효.
Objective To compare the application of transanal endoscopic microsurgery (TEM) technique with Mason's operation in the treatment of early rectal cancer. Methods Patients with early rectal cancer were divided into two groups according to different surgical procedures they underwent during different period.Patients in Mason Group underwent Mason's operations during the period from January 2000 to March 2006 ; and in TEM Group were managed with TEM procedures from April 2006 to July 2011.There were 21 patients in TEM Group and 26 patients in Mason Group.No statistically significant difference was found between the two groups in terms of patient's age,gender,preoperative TNM staging,and tumor diameter.In comparison with Mason Group,TEM Group had a longer distance of the tumor from the anal verge. The safety, postoperative complications, patients' postoperative recovery, and the oncological outcomes of 2 groups were compared with each other.Results No perioperative death occurred in the two groups.The TEM Group had notably shorter operating time ( (67 ± 24)minutes) and lesser intra-operative blood loss ( (9 ±6)ml) than Mason Group (t =3.526 and 7.078,P ＜0.05).The time of the postoperative bed rest,the urinary drainage,the recovery of oral intake,and the hospital stay in TEM Group were (1.3 ±0.5) days,(1.2 ±0.4) days,(1.5±0.5) days,and (4.3±1.6) days,respectively,and all were prominently shorter than those of Mason group (t =4.925-14.640,P ＜ 0.05 ).Patients in TEM group were followed up for an average of 36.5 months with one patient being lost,while patients in Mason group were followed up for an average of 81.6 months. The difference between the two groups in terms of short-term accumulated survival ( 94.8％ vs.96.3％ ) showed no statistical significance ( P ＞ 0.05 ).Conclusion TEM technique is a favorable minimally invasive procedure associated with satisfactory oncological outcomes in the treatment of early rectal cancer.
