经肛门微创手术与内镜黏膜下剥离术治疗直肠病变:社区医院的经验。

IF 1.1 4区 医学 Q3 SURGERY
Jau-Jie You, Ming-Yin Shen, William Tzu-Liang Chen, Jiun-Wei Fan, Yen-Chen Shao, Chun-Lung Feng, Chu-Cheng Chang, Yu-Hao Su, Abe Fingerhut
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引用次数: 0

摘要

背景:比较经肛门微创手术(TAMIS)和内镜黏膜下剥离术(ESD)治疗巨大或恶性直肠腺瘤性息肉的肿瘤边缘和手术效果。方法:对接受 TAMIS 或 ESD 手术的患者进行单机构回顾性分析。结果:共纳入了 30 名接受 TAMIS(19 人)或 ESD(11 人)手术的连续患者,他们的人口统计学特征相似。TAMIS和ESD的肿瘤距离肛门边缘的中位数(四分位数间距,IQR)分别为5厘米(3.5-8)和3厘米(2-4.25)(P = 0.016)。TAMIS 中有 4 例,ESD 中有 2 例,肿瘤占据了肠腔周长的一半以上。TAMIS和ESD中分别有5例(4例原位和1例1期)和2例(1例原位和1例1期)为恶性肿瘤。TAMIS和ESD标本的中位长度、宽度和高度分别为3.2厘米、2.6厘米和1.0厘米,以及3.5厘米、2.0厘米和0.3厘米。肿瘤周长、恶性比率或标本大小在统计学上没有明显差异。两例ESD患者的切除边缘受累,而TAMIS患者的切除边缘均未受累(P = 0.041)。TAMIS和ESD的中位(IQR)手术时间分别为72(62-89)分钟和120(90-180)分钟(P = 0.005)。TAMIS和ESD的中位(IQR)随访时间分别为3.3(0.3-11.7)个月和0.9(0.3-15.4)个月。两组患者均无发病、死亡或局部复发。结论:在社区医院实践中,TAMIS和ESD都是可行和安全的。手术时间更短,而且 TAMIS(与 ESD 相比)没有涉及边缘。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transanal Minimally Invasive Surgery Versus Endoscopic Submucosal Dissection for Rectal Lesions: A Community Hospital Experience.

Background: To compare tumor margins and surgical outcomes between transanal minimally invasive surgery (TAMIS) and endoscopic submucosal dissection (ESD) for large or malignant rectal adenomatous polyps. Methods: Single institution retrospective analysis of patients who underwent TAMIS or ESD surgery. Results: In total, 30 consecutive patients with similar demographics who underwent either TAMIS (n = 19) or ESD (n = 11) were included. The median (interquartile range, IQR) tumor distances from the anal verge for TAMIS and ESD were 5 cm (3.5-8) and 3 cm (2-4.25) (P = 0.016). Four in TAMIS and two in ESD occupied more than half of the circumference of the bowel lumen. Five (four in situ and one stage 1) in TAMIS and two (one in situ and one stage 1) in ESD were malignant. The median specimen length, width, and height were 3.2 cm, 2.6 cm, and 1.0 cm and 3.5 cm, 2.0 cm, and 0.3 cm for TAMIS and ESD, respectively. There were no statistically significant differences in tumor circumference, malignant ratios, or specimen sizes. Resection margins were involved in two of the ESD, while none of the TAMIS were involved (P = 0.041). The median (IQR) operative time was 72 (62-89) minutes and 120 (90-180) minutes for TAMIS and ESD (P = 0.005). The median (IQR) follow-up time was 3.3 (0.3-11.7) and 0.9 (0.3-15.4) months for TAMIS and ESD. There were no morbidities, no mortalities, or local recurrences among the two groups. Conclusions: Both TAMIS and ESD were found to be feasible and safe in community hospital practice. Operative time was shorter, and there were no involved margins in TAMIS (versus ESD).

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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