将一种新型开环肛门镜，应用于组织选择性直肠黏膜切除吻合术（TST）中，并评估此方法的临床疗效及安全性。

选择Ⅲ、Ⅳ度脱垂性痔患者48例为研究对象，使用开环肛门镜进行经肛吻合器手术。观察手术操作及完成情况、切除组织量、手术耗时、术后住院时间、术后疼痛评分、肛门坠胀感、有无并发症等情况。

48例患者均顺利完成手术，无中止手术或中途变更手术方案。术中操作顺利，无器械异常、脱钉、不能击发等情况。术中出血少，未出现难以控制的出血。平均手术耗时（21.3±5.5）分钟，平均切除组织量（11.6±1.9）mL，术后平均住院时间为（4.8±1.7）天。术后随访6个月，全组患者均未出现肛管直肠的临床狭窄及潜在的亚临床相对狭窄。

将开环肛门镜应用于TST中，可以实现选择性切除足够的脱垂黏膜，同时保存部分正常的直肠壁，可从技术源头上避免直肠狭窄、直肠阴道瘘等严重并发症的出现，同时术后疼痛、肛门坠胀感、排便感觉障碍等症状也相对较轻，可视为一种操作简单、安全、有效的手术方式。

A new type of open-loop anoscope was used in tissue selective rectal mucosal resection and anastomosis (TST), and the clinical efficacy and safety of this method were evaluated.

Forty-eight patients with grade Ⅲ and Ⅳ prolapsed hemorrhoids were selected as subjects, and an anal anastomat was performed using an open-loop anoscope. Observe the operation and completion, the amount of tissue removed, the time spent on surgery, the length of postoperative hospital stay, the postoperative pain score, the feeling of anal bulge, and the presence or absence of complications.

All 48 patients successfully completed the operation without interruption or midway change of the surgical plan. Intraoperative operation is smooth, no abnormalities in the instrument, nail removal, and failure to fire. There was less bleeding during the operation and no uncontrollable bleeding occurred. The average operation time was (21.3±5.5) minutes, the average tissue resection amount was (11.6±1.9) mL, and the average postoperative hospital stay was (4.8±1.7) days. After 6 months of follow-up, there was no clinical stenosis and potential subclinical relative stenosis in the entire group.

The application of open-loop anal mirror in TST can selectively remove enough prolapsed mucosa while preserving part of the normal rectal wall, avoiding serious complications such as rectal stenosis and rectal vaginal fistula from the technical source. Postoperative pain, anal bulge, and defecation dysfunction are also relatively mild, which can be regarded as a simple, safe and effective surgical procedure.