Surgical cure for early rectal carcinoma and large adenoma: transanal endoscopic microsurgery (using ultrasound or electrosurgery) compared to conventional local and radical resection.
作者： C. Langer , T. Liersch , M. Süss , A. Siemer , P. Markus
DOI: 10.1007/S00384-002-0441-4
关键词: Medicine 、 Surgery 、 Carcinoma 、 Colostomy 、 Abdominoperineal resection 、 Survival rate 、 Proctoscopy 、 Microsurgery 、 Radical surgery 、 Electrosurgery
摘要: Abstract Background and aims. The minimally invasive technique of transanal endoscopic microsurgery (TEM) combines the benefits local resections, a low complication rate high patient comfort, with recurrence excellent survival after radical surgery (RS). use an ultrasonically activated scalpel rather than electrosurgery further improves results TEM. Patients methods. A retrospective study was performed 182 operations on 162 patients early rectal carcinoma (pT1, G1/2) or adenoma to compare outcome following four different kinds surgical resection techniques: RS (anterior abdominoperineal resection; n=27), conventional using Park's retractor (TP; n=76), (TEM-ES; n=45), TEM UltraCision (TEM-UC; n=34). One-third (33%) received either colostomy protective loop-ileostomy. Results. Operation time TEM-UC significantly shorter TEM-ES RS. Hospitalization longer for TP. Complication lower Recurrence TP, trend being better TEM-ES. Mortality 3.7% 0 TP 2-year 96.3% 100% each Conclusion. UC seems be choice. leads unacceptable rate, in higher incidence impairment life quality.
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