中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2009年
12期
2129-2130
,共2页
方建明%方跃君%朱松太%李君达
方建明%方躍君%硃鬆太%李君達
방건명%방약군%주송태%리군체
超声检查%直肠肿瘤%局部切除
超聲檢查%直腸腫瘤%跼部切除
초성검사%직장종류%국부절제
Uhrasonography%Rectal neoplasms%Local resection
目的 探讨低侵袭经肛超声刀局部切除治疗直肠腺瘤恶变和早期直肠癌的疗效和优越性.方法 对15例直肠腺瘤恶变和早期直肠癌患者经肛门行局部切除术,采用5 mm超声刀将直肠肿瘤完整切除(黏膜下或肌浅层),手术创口在腔内连续缝合.结果 15例直肠腺瘤恶变、早期直肠癌均完整切除,切缘及基底均阴性,手术时间30～180 min,平均60 min,术中出血0～30 ml,平均10 ml;手术并发症:暂时性排气失控2例,急性尿潴留1例.术后病理:绒毛状腺瘤伴高级别上皮内瘤变8例,混合性腺瘤恶变2例,黏膜内癌5例.15例随访4～48个月,平均18个月,肿瘤无原位复发.结论 低侵袭经肛超声刀局部切除治疗直肠腺瘤恶变和早期直肠癌是一种安全有效的手术方法 ,且保肛,提高了患者的生存质量.
目的 探討低侵襲經肛超聲刀跼部切除治療直腸腺瘤噁變和早期直腸癌的療效和優越性.方法 對15例直腸腺瘤噁變和早期直腸癌患者經肛門行跼部切除術,採用5 mm超聲刀將直腸腫瘤完整切除(黏膜下或肌淺層),手術創口在腔內連續縫閤.結果 15例直腸腺瘤噁變、早期直腸癌均完整切除,切緣及基底均陰性,手術時間30～180 min,平均60 min,術中齣血0～30 ml,平均10 ml;手術併髮癥:暫時性排氣失控2例,急性尿潴留1例.術後病理:絨毛狀腺瘤伴高級彆上皮內瘤變8例,混閤性腺瘤噁變2例,黏膜內癌5例.15例隨訪4～48箇月,平均18箇月,腫瘤無原位複髮.結論 低侵襲經肛超聲刀跼部切除治療直腸腺瘤噁變和早期直腸癌是一種安全有效的手術方法 ,且保肛,提高瞭患者的生存質量.
목적 탐토저침습경항초성도국부절제치료직장선류악변화조기직장암적료효화우월성.방법 대15례직장선류악변화조기직장암환자경항문행국부절제술,채용5 mm초성도장직장종류완정절제(점막하혹기천층),수술창구재강내련속봉합.결과 15례직장선류악변、조기직장암균완정절제,절연급기저균음성,수술시간30～180 min,평균60 min,술중출혈0～30 ml,평균10 ml;수술병발증:잠시성배기실공2례,급성뇨저류1례.술후병리:융모상선류반고급별상피내류변8례,혼합성선류악변2례,점막내암5례.15례수방4～48개월,평균18개월,종류무원위복발.결론 저침습경항초성도국부절제치료직장선류악변화조기직장암시일충안전유효적수술방법 ,차보항,제고료환자적생존질량.
Objective To evaluate the curative effect and superiority of minimally invasive transanal surgery in the treatment of cancerate rectal adenoma and early rectal cancer by using CUSA.Method Local resection was clone in 15 patients with cancerate rectal adenoma or early rectal cancer,the tumours were excised intactly by 5 mm CUSA(submucosal or superficial muscularis),the incisions were closed by continuous suture in the lumen.Results All of the tumours were excised intactly,the incisal edges and funduses were all negative.The operation time was 30～180 min,average:60 min,the amount of bleeding during operation was 0～30 ml,average:10 ml.Complications:temporary fecal incontinence in 2 cases,acute urinary retention in 1 case.Pathology after operation:villous adenoma accompanied by high grade intra epithelial neoplasia in 8 cases,mixed adenoma in 2 cases,intra-mucosal carcinoma in 5 cases.15cases were followed up 4～48 months,averge 18 months,no tumour recur in original place.Conclusion Minimally invasive transanal surgery by CUSA is a safe and effective operation in the treatment of cancerate rectal adenoma and early rectal cancer.It can keep the anus and improve the quality of life.
