Deng Qun, Liao Xiujun, Yang Guangen, Mao Weiming, Shen Zhong, Liu Zhiyong, Ding Jing, Zhang Xiufeng, Yu Yanyan
Department of Coloproctology, The Third People's Hospital of Hangzhou, Hangzhou 310009, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2014 May;17(5):473-5.
To evaluate the feasibility and efficacy of transanal endoscopic microsurgery (TEM) by transanal glove port combined with colonoscopy for excision of rectal tumors.
Eight patients with rectal cancer eligible for local resection were chosen to receive a procedure performed via a "glove TEM port" from October 2012 to March 2013. This device was constructed on-table using a circular anal dilator (CAD), standard surgical glove, colonoscopy instruments and straight laparoscopic instruments.
Procedures of all the patients were completed successfully by glove TEM. The median (range) diameter of tumor was 2.6(1.5-3.5) cm, the median (range) operative time was 55.6(30-110) min. Postoperative pathology included villous adenomas (n=3), tubular adenomas (n=2), tubulovillous adenomas (n=2), serrated adenoma (n=1), low-grade intraepithelial neoplasia (n=2), and high-grade intraepithelial neoplasia (n=1). All resection margins were negative. Two patients presented with postoperative minor bleeding. There were no serious intraoperative complications. No cancer recurrence was found during a follow-up of 1-5 (median 3.1) months.
Transanal endoscopic microsurgery by transanal glove port combined with colonoscopy in the treatment of early rectal cancer is easy and safe.
评估经肛门手套端口联合结肠镜检查行经肛门内镜显微手术（TEM）切除直肠肿瘤的可行性和疗效。
选取2012年10月至2013年3月间8例适合局部切除的直肠癌患者，采用“手套TEM端口”进行手术。该装置在手术台上使用圆形肛门扩张器（CAD）、标准手术手套、结肠镜器械和直腹腔镜器械构建而成。
所有患者均通过手套TEM成功完成手术。肿瘤的中位（范围）直径为2.6（1.5 - 3.5）cm，中位（范围）手术时间为55.6（30 - 110）分钟。术后病理包括绒毛状腺瘤（n = 3）、管状腺瘤（n = 2）、管状绒毛状腺瘤（n = 2）、锯齿状腺瘤（n = 1）、低级别上皮内瘤变（n = 2）和高级别上皮内瘤变（n = 1）。所有切除边缘均为阴性。2例患者术后出现轻微出血。无严重术中并发症。在1 - 5（中位3.1）个月的随访期间未发现癌症复发。
经肛门手套端口联合结肠镜检查行经肛门内镜显微手术治疗早期直肠癌简便且安全。
