Ribeiro da Rocha J J, Féres O
Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Tech Coloproctol. 2008 Sep;12(3):241-6. doi: 10.1007/s10151-008-0429-3. Epub 2008 Aug 5.
Transanal access is one of many currently used procedures for rectal cancer treatment. The techniques used for local excision include conventional transanal excision, posterior access, therapeutic colonoscopy and transanal endoscopic approaches. The aim of the present study was to present a new surgical proctoscope for the endoscopic transanal excision of rectal lesions. A cylindrical proctoscope with a diameter of 4 cm was devised and built. The end inserted into the anus has a bevelled aspect and rounded borders, allowing correct exposure of the anal lesion. The rectoscope is fixed to the anal border with surgical thread through perforations in the external end. A base screw holds a fibre-light which illuminates the operative field. Part of the equipment is a guide which is positioned inside the rectoscope on insertion into the anus. In operations utilizing this proctoscope, 17 adenomas, 25 adenocarcinomas, 1 carcinoid and 1 endometrioma were excised. The diameter of the lesions varied from 1 to 6 cm. The range of procedures that are possible with this new proctoscope are similar to those achieved with conventional techniques which, however, require more expensive equipment. Hence, the present study demonstrates that this newly devised low-cost proctoscope is an efficient tool for the transanal endoscopic excision of rectal lesions.
经肛门入路是目前用于直肠癌治疗的多种手术方法之一。用于局部切除的技术包括传统经肛门切除、后路入路、治疗性结肠镜检查和经肛门内镜手术方法。本研究的目的是介绍一种用于直肠病变内镜经肛门切除的新型手术直肠镜。设计并制造了一种直径为4厘米的圆柱形直肠镜。插入肛门的一端呈斜面且边缘圆润，能够正确暴露肛门病变。直肠镜通过其外端的穿孔用手术线固定在肛门边缘。一个底座螺丝固定着一个纤维光源，照亮手术视野。该设备的一部分是一个导向器，在插入肛门时放置在直肠镜内。在使用这种直肠镜的手术中，切除了17个腺瘤、25个腺癌、1个类癌和1个子宫内膜瘤。病变直径从1厘米到6厘米不等。这种新型直肠镜所能进行的手术范围与传统技术相似，然而传统技术需要更昂贵的设备。因此，本研究表明，这种新设计的低成本直肠镜是用于直肠病变经肛门内镜切除的有效工具。
