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经肛门微创手术(TAMIS)治疗直肠各种病变的可行性及优势

Feasibility and Advantages of Transanal Minimally Invasive Surgery (TAMIS) for Various Lesions in the Rectum.

作者信息

Kang Min Kyu, Shin Rumi, Sohn Beong-Hoon, Heo Seung-Chul

机构信息

Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.

出版信息

J Minim Invasive Surg. 2020 Mar 15;23(1):36-42. doi: 10.7602/jmis.2020.23.1.36.

Abstract

PURPOSE

We report our experience in the use of transanal minimally invasive surgery (TAMIS) and the feasibility and safety of this surgical technique in operating for various rectal diseases that require a transanal approach.

METHODS

Between 2013 and 2019, 30 patients underwent TAMIS for a rectal lesion at Seoul National University Boramae Medical Center. The clinical data including age, gender, body mass index, tumour size, distance from the anal verge, diagnosis, operation time, postoperative complications, duration of hospital stay, and post-operative margin status were obtained retrospectively from the electronic medical records.

RESULTS

The mean operation time was 52.1±33.5 and the mean duration of hospital stay after surgery was 4.3±4.2 days. Most of the patients had undergone TAMIS for neuroendocrine tumor (NET) (60%) followed by an adenoma (16.7%) and rectal cancer (13.3%). 4 patients (13.3%) had minor complications after TAMIS. 2 patients (50%) had complained of diarrhea, 1 patient (25%) complained of fecal incontinence and 1 patient (25%) been diagnosed fluid in the operation bed.

CONCLUSION

TAMIS is a useful method for local excision of rectal lesion located in mid to upper rectum as well as other rectal pathologies that require a transanal approach.

摘要

目的

我们报告经肛门微创手术(TAMIS)的应用经验,以及该手术技术用于治疗各种需要经肛门入路的直肠疾病的可行性和安全性。

方法

2013年至2019年期间,首尔国立大学博拉梅医疗中心有30例患者因直肠病变接受了TAMIS手术。从电子病历中回顾性获取临床数据,包括年龄、性别、体重指数、肿瘤大小、距肛缘距离、诊断、手术时间、术后并发症、住院时间以及术后切缘状态。

结果

平均手术时间为52.1±33.5分钟,术后平均住院时间为4.3±4.2天。大多数患者因神经内分泌肿瘤(NET)接受TAMIS手术(60%),其次是腺瘤(16.7%)和直肠癌(13.3%)。4例患者(13.3%)在TAMIS术后出现轻微并发症。2例患者(50%)主诉腹泻,1例患者(25%)主诉大便失禁,1例患者(25%)被诊断为手术床内有积液。

结论

TAMIS是一种用于局部切除位于直肠中上部的直肠病变以及其他需要经肛门入路的直肠疾病的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3c1/8985647/90b31431ec8f/JMIS-23-1-036-f1.jpg

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