Kato K, Saito T, Matsuda M, Imai M, Kasai S, Mito M
Second Department of Surgery, Asahikawa Medical College, 4-5 Nishi-Kagura, Asahikawa, 078 Japan.
Surg Endosc. 1997 May;11(5):485-7. doi: 10.1007/s004649900398.
We report the advantage of employing transanal endoscopic microsurgery (TEM) using the contact Nd:YAG laser for the treatment of a rectal anastomotic stenosis. A 72-year-old woman was admitted to our hospital with a postoperative rectal anastomotic stenosis. Twenty months prior to admission, the patient underwent a low anterior resection for the treatment of the rectal cancer using an EEA stapling device. A barium enema and colonoscopy revealed a rectal stenosis, 0.8-cm diameter. This stenosis was at the anastomotic site, approximately 4.0 from the dental line. An endoscopic treatment was performed transanally using the contact Nd:YAG laser. The stenotic rectal wall was fulgurated or vaporized completely. There were no intraoperative or postoperative complications. We concluded that TEM appears to be a safe and minimally invasive procedure. Furthermore, the contact Nd:YAG laser is very effective in treating the gastrointestinal stenotic area. To our knowledge, this is the first successful report of this novel procedure.
我们报告了采用接触式Nd:YAG激光经肛门内镜显微手术（TEM）治疗直肠吻合口狭窄的优势。一名72岁女性因术后直肠吻合口狭窄入住我院。入院前20个月，该患者使用EEA吻合器进行了低位前切除术以治疗直肠癌。钡剂灌肠和结肠镜检查显示直肠狭窄，直径0.8厘米。该狭窄位于吻合口处，距齿状线约4.0厘米。使用接触式Nd:YAG激光经肛门进行了内镜治疗。狭窄的直肠壁被完全电凝或汽化。术中及术后均无并发症。我们得出结论，TEM似乎是一种安全且微创的手术。此外，接触式Nd:YAG激光在治疗胃肠道狭窄区域非常有效。据我们所知，这是关于这种新手术的首例成功报告。
