Coloproctology Unit. General and Digestive Surgery Service, Parc Tauli University Hospital, Sabadell, Universitat Autonoma de Barcelona, Parc Tauli s/n, 08208, Sabadell (Barcelona), Spain.
Coloproctology Unit. General and Digestive Surgery Service, Parc Tauli University Hospital, Sabadell, Universitat Autonoma de Barcelona, Parc Tauli s/n, 08208, Sabadell (Barcelona), Spain.
Am J Surg. 2019 Jan;217(1):53-58. doi: 10.1016/j.amjsurg.2018.04.014. Epub 2018 Apr 22.
The aim of this study is to assess postoperative morbidity and mortality in tumors with a proximal margin 15 cm or more from the anal verge operated with transanal endoscopic microsurgery (TEM).
This observational study of consecutive rectal tumor patients undergoing TEM was carried out from July 2004 to June 2017. We compared the results of rectal tumors at distances of ≥15 cm (group A) and <15 cm (group B) from the anal verge.
During the study period 667 patients were included: 118 in group A and 549 in group B. In the comparative analysis there were no significant differences in morbidity (p = 0.23), mortality (p = 0.32) or free margin involvement (p = 0.545). Differences were observed in terms of lesion size (p < 0.001), surgical time (p < 0.001) and peritoneal cavity perforation, which were all increased in group A.
TEM for lesions in the rectosigmoid junction is feasible and is not associated with higher morbidity or mortality.
本研究旨在评估距离肛门缘 15cm 或以上的经肛门内镜微创手术（TEM）治疗的肿瘤的术后发病率和死亡率。
本研究为连续直肠肿瘤患者接受 TEM 的观察性研究，于 2004 年 7 月至 2017 年 6 月进行。我们比较了距离肛门缘≥15cm（A 组）和<15cm（B 组）的直肠肿瘤的结果。
在研究期间共纳入 667 例患者：A 组 118 例，B 组 549 例。在对比分析中，发病率（p=0.23）、死亡率（p=0.32）或游离边缘受累（p=0.545）无显著差异。在病变大小（p<0.001）、手术时间（p<0.001）和腹膜腔穿孔方面存在差异，A 组均增加。
TEM 治疗直肠乙状结肠交界处病变是可行的，与更高的发病率或死亡率无关。
