经肛门直肠镜辅助内镜下黏膜剥离微创手术混合技术切除大型直肠息肉：病例报告
Removal of a large rectal polyp with endoscopic submucosal dissection-trans-anal rectoscopic assisted minimally invasive surgery hybrid technique: A case report.
作者信息
Polese Lino
机构信息
Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova 35128, Italy.
出版信息
World J Gastrointest Surg. 2023 Dec 27;15(12):2932-2937. doi: 10.4240/wjgs.v15.i12.2932.
BACKGROUND
Endoscopic submucosal dissection (ESD) can be used for the removal of superficial rectal lesions; however, the lack of a traction system makes the procedure long and difficult in the presence of extensive lesions.
CASE SUMMARY
A large polyp occupying 2/3 of the rectal circumference and extending 5 cm in length was removed by ESD with the help of laparoscopic forceps introduced trans-anal rectoscopic assisted minimally invasive surgery, a disposable platform designed to aid in transanal minimally invasive surgery. Traction of the polyp by forceps during the operation was dynamic, and applied at various points and in various directions. The polyp was removed c without complications in 1 h and 55 min. A sigmoidoscopy performed 50 d later showed normal healing without polyp recurrence.
CONCLUSION
The technique presented here could overcome the issues caused by lack of traction during ESD for rectal lesions.
背景
内镜黏膜下剥离术（ESD）可用于切除直肠浅表病变；然而，在存在广泛病变的情况下，由于缺乏牵引系统，该手术耗时且操作困难。
病例摘要
借助经肛门直肠镜辅助微创手术引入的腹腔镜钳，通过ESD切除了一个占据直肠周长2/3且长度达5 cm的大息肉，经肛门直肠镜辅助微创手术是一种旨在辅助经肛门微创手术的一次性平台。手术过程中通过钳子对息肉进行的牵引是动态的，且在不同点和不同方向施加。息肉在1小时55分钟内顺利切除，无并发症。术后50天进行的乙状结肠镜检查显示愈合正常，无息肉复发。
结论
本文介绍的技术可以克服ESD治疗直肠病变时因缺乏牵引而导致的问题。
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