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经腹腔镜行家族性腺瘤性息肉病直肠结肠切除术患者中 taTME 的初步经验。

Initial experience with taTME in patients undergoing laparoscopic restorative proctocolectomy for familial adenomatous polyposis.

机构信息

Department of Surgery, Helios University Hospital Wuppertal, Witten/Herdecke University, Heusnerstr. 40, 42283, Wuppertal, Germany.

Center for Hereditary Tumor Diseases, Helios University Hospital Wuppertal, Witten/Herdecke University, Witten, Germany.

出版信息

Tech Coloproctol. 2017 Dec;21(12):971-974. doi: 10.1007/s10151-017-1730-9. Epub 2017 Nov 22.

Abstract

BACKGROUND

Transanal total mesorectal excision (taTME) is a minimally invasive technique which was developed to overcome the difficulties associated with the "top-down" pelvic dissection by enabling a "bottom-up" dissection in patients with mid- and low rectal cancer. While this technique was primarily designed to manage tumors in the mid- and lower rectum, its spectrum of indications has been broadened to include benign colorectal pathologies. The aim of the present study was to assess our initial experience with taTME in patients undergoing restorative proctocolectomy for familial adenomatous polyposis (FAP).

METHODS

All consecutive patients (undergoing prophylactic restorative proctocolectomy with IPAA for FAP using taTME between April and October 2016 at our institution) were included in the study.

RESULTS

There were 8 patients (6 females and 2 males). The median age was 19.5 years (range 16-31 years). In all cases, surgery was successfully completed using with taTME. No perioperative complications were recorded. A median of 5 bowel movements (range 4-6 bowel movements) with intermittent anti-diarrheal medication was recorded in all cases.

CONCLUSIONS

Our initial experience with 8 consecutive cases suggests taTME is safe and effective in patients undergoing prophylactic restorative proctocolectomy with IPAA for FAP.

摘要

背景

经肛门全直肠系膜切除术(taTME)是一种微创技术,旨在通过在中低位直肠癌患者中实现“自下而上”的解剖来克服“自上而下”的盆腔解剖困难。虽然该技术主要用于治疗中低位直肠肿瘤,但它的适应证范围已扩大到包括良性结直肠病变。本研究旨在评估我们在接受家族性腺瘤性息肉病(FAP)预防性直肠结肠切除术的患者中应用 taTME 的初步经验。

方法

所有连续患者(在我们机构接受 taTME 预防性直肠结肠切除术和 IPAA 治疗 FAP,时间为 2016 年 4 月至 10 月)均纳入本研究。

结果

共有 8 例患者(6 名女性和 2 名男性)。中位年龄为 19.5 岁(范围 16-31 岁)。所有病例均成功完成 taTME 手术。无围手术期并发症。所有病例均间歇性使用抗腹泻药物,记录的平均排便次数为 5 次(范围 4-6 次)。

结论

我们在 8 例连续病例中的初步经验表明,taTME 在接受预防性直肠结肠切除术和 IPAA 治疗 FAP 的患者中是安全有效的。

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