论文部分内容阅读
目的探讨经肛门汽化电切术切除直肠下段腺瘤的安全性和可行性。方法 30例距肛缘7cm的直肠腺瘤患者接受经肛门汽化电切治疗,连硬膜外麻醉后取截石位,经肛门插入F25.5 Wolf前列腺汽化电切镜,4%甘露醇冲洗液持续低压灌洗。采用Spray电切模式,用环状电极切除肿块至肌层并电凝周围1cm粘膜,冲出肿块组织,放置肛管引流。结果 30例手术均顺利,手术时间平均30min。术后无出血、水中毒、脓毒血症及肠穿孔。术后规律结肠镜检查随访,平均随访6-65月。25例单发直肠腺瘤术后无复发,5例多发腺瘤患者中3例复发,2例再次行汽化电切,1例因直肠多发腺瘤癌变接受经腹会阴直肠肿瘤根治性切除、降结肠造口术。结论经肛汽化电切术切除直肠下段腺瘤安全有效,术式可选。
Objective To investigate the safety and feasibility of transanal vaporization resection of lower rectal adenoma. Methods Thirty patients with rectal adenomas with an anastomotic margin of 7 cm were treated with transesophageal electrovaporization. Epidural anesthesia was performed to obtain the lithotomy position. F25.5 Wolf prostatic erosive resectoscope and 4% mannitol rinse Continuous low pressure lavage. Using Spray mode, with a circular electrode excision mass to the muscle and coagulation around the 1cm mucosa, out of the mass of the tumor, place the anal canal drainage. Results All the 30 surgeries were successful and the average operation time was 30 minutes. No postoperative bleeding, water poisoning, sepsis and intestinal perforation. Postoperative regular colonoscopy follow-up, an average of 6 - 65 months follow-up. No recurrence was found in 25 patients with single rectal adenoma, 3 of 5 patients with recurrent adenoma recurred, 2 with revascularization and 1 with radical resection of perinephric carcinoma due to rectal multiple adenoma Colostomy. Conclusions Transanal vaporization resection of the lower rectal adenoma is safe and effective.