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使用腹腔镜器械的经肛门直肠微创手术:综述

Transanal minimally invasive surgery using laparoscopic instruments of the rectum: A review.

作者信息

Kim Myung Jo, Lee Taek-Gu

机构信息

Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, South Korea.

出版信息

World J Gastrointest Surg. 2021 Oct 27;13(10):1149-1165. doi: 10.4240/wjgs.v13.i10.1149.

Abstract

Transanal minimally invasive surgery (TAMIS) was first described in 2010 as an alternative to transanal endoscopic microsurgery (TEM). The TAMIS technique can be access to the proximal and mid-rectum for resection of benign and early-stage malignant rectal lesions and also used for noncurative intent surgery of more advanced lesions in patients who are not candidates for radical surgery. TAMIS has a shorter learning curve, reduced device setup time, flexibility in instrument use, and versatility in application than TEM. Also, TAMIS shows similar results in a view of the operation time, conversion rate, reoperation rate, and complication to TEM. For these reasons, TAMIS is an easily accessible, technically feasible, and cost-effective alternative to TEM. Overall, TAMIS has enabled the performance of high-quality local excision of rectal lesions by many colorectal surgeons. As TAMIS becomes more broadly utilized such as pelvic abscess drainage, rectal stenosis, and treatment of anastomotic dehiscence, the acquisition of appropriate training must be ensured, and the continued assessment and assurance of outcome must be maintained.

摘要

经肛门微创手术(TAMIS)于2010年首次被描述为经肛门内镜显微手术(TEM)的一种替代方法。TAMIS技术可用于直肠近端和中段,以切除良性和早期恶性直肠病变,也可用于对不适合根治性手术的更晚期病变进行非根治性手术。与TEM相比,TAMIS的学习曲线更短,设备设置时间更短,器械使用更灵活,应用更广泛。此外,在手术时间、转化率、再次手术率和并发症方面,TAMIS与TEM的结果相似。由于这些原因,TAMIS是一种易于获得、技术上可行且具有成本效益的TEM替代方法。总体而言,TAMIS使许多结直肠外科医生能够高质量地局部切除直肠病变。随着TAMIS在盆腔脓肿引流、直肠狭窄和吻合口裂开治疗等方面得到更广泛的应用,必须确保获得适当的培训,并持续评估和保证手术效果。

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