Saclarides T J, Smith L, Ko S T, Orkin B, Buess G
Department of General Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612.
Dis Colon Rectum. 1992 Dec;35(12):1183-91. doi: 10.1007/BF02251975.
Transanal endoscopic microsurgery (TEM) has emerged as a minimally invasive means of resecting rectal tumors. Developed in Germany and now being used with increasing frequency in the United States, TEM utilizes a 40-mm operating rectoscope, which is sealed with an airtight facepiece. Carbon dioxide is constantly infused, thereby distending the rectum and maintaining visibility. A variety of instruments, such as tissue graspers, a high-frequency knife, suction, and needle holders, are inserted through the facepiece. Adenomas that are small, large, or even circumferential, as well as selected carcinomas up to 24 cm, can be removed with TEM instrumentation. The optics provide sixfold magnification, and this, combined with the constantly distended operative field, allows for a precise excision of the tumor as well as closure of the wound. For lesions in the mid and upper rectum, TEM is an alternative to a transsacral or transabdominal approach, with subsequently shorter hospital stay and fewer complications.
经肛门内镜显微手术（TEM）已成为一种切除直肠肿瘤的微创方法。该技术由德国研发，目前在美国的使用频率越来越高。TEM使用一个40毫米的手术直肠镜，其通过气密面罩密封。持续注入二氧化碳，从而扩张直肠并保持视野清晰。各种器械，如组织钳、高频刀、吸引器和持针器，可通过面罩插入。小型、大型甚至环状腺瘤，以及某些长度达24厘米的癌肿，都可以使用TEM器械切除。其光学系统提供6倍放大倍率，再加上持续扩张的手术视野，使得肿瘤能够被精确切除，伤口也能得以缝合。对于直肠中上部的病变，TEM是经骶骨或经腹手术的替代方法，术后住院时间更短，并发症更少。
