경항문 내시경 미세수술의 임상적 고찰
Clinical Results of Transanal Endoscopic Microsurgery (TEM)
정준철, 장원영, 최성일, 이우용, 전호경, 오소향, 이두석, 노상의,
소속 상세정보
정준철 ( Chung Jun-Chul )
성균관대학교 의과대학 삼성서울병원 외과
장원영 ( Chang Weon-Young )
성균관대학교 의과대학 외과학교실
최성일 ( Choi Sung-Il )
성균관대학교 의과대학 삼성서울병원 일반외과
이우용 ( Lee Woo-Young )
성균관대학교 의과대학 삼성서울병원 일반외과
전호경 ( Jun Ho-Kyung )
성균관대학교 의과대학 삼성서울병원 일반외과
오소향 ( Oh So-Hyang )
성균관대학교 의과대학 삼성서울병원 일반외과
이두석 ( Lee Doo-Suk )
성균관대학교 의과대학 삼성서울병원 외과학교실
노상의 ( Noh Sang-Eu )
성균관대학교 의과대학 삼성서울병원 외과학교실
KMID : 0356720020180020104
Abstract
Purpose: Local treatment of rectal tumors have become an alternative to the classic radical operation. However, conventional transanal procedures are limited to tumors located in the lower rectum and the precision of the excision is
restricted by the limitation of the surgeon’s visualization during the procedure. This report will present our surgical management and functional results after TEM, a new minimally invasive technique for the treatment of rectal tumors.
Methods: From December 1994 to January 2000, 136 patients underwent TEM. All patients were evaluated preoperatively with sigmoidoscopy or colonoscopy with biopsy. The indications for TEM were benign rectal tumors and T1 and T2 malignant rectal tumors with well or moderately differentiation. All patients were followed up 1 month postoperatively and every 3 months thereafter.
Results: The mean operation time was 56.5 minutes (25∼150 minutes) and the mean postoperative hospital stay was 3.6 days (2∼10 days). On the basis of the postoperative evaluations, 56 of the 136 patients proved to have benign tumors while the remaining 80 patients had malignant tumors. One hundred thirty five patients were removed with adequate resection margins. One patient had cancer cell involvement at the resection margin. There were no serious complications. After a mean observation time of 29 months (12∼42 months), there were five noted recurrences. Functional results were excellent; 24 of the 136 patients complained of impaired continence or defecation disorders in a review one month postoperatively. These problems improved during the first 6 months after the surgery.
Conclusions: We feel that TEM is an adequate method for removal of benign rectal tumors, and properly selected early rectal cancers.
키워드
경항문 내시경 미세수술;직장 종양
Transanal endoscopic microsurgery;Rectal tumor
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