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中华结直肠疾病电子杂志 ›› 2019, Vol. 08 ›› Issue (02) : 109 -114. doi: 10.3877/cma.j.issn.2095-3224.2019.02.001

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经肛门内镜微创手术应用的新进展
薛晓强1, 林国乐1,()   
  1. 1. 100730 北京,中国医学科学院 北京协和医学院 北京协和医院基本外科
  • 收稿日期:2018-07-17 出版日期:2019-04-25
  • 通信作者: 林国乐
  • 基金资助:
    北京市科技重大专项基金(No.D171100002617003); 2014年度北京协和医学院青年教师培养项目(No.2014zlgc0720)

Updates on the applications and indications of the technique of transanal endoscopic microsurgery

Xiaoqiang Xue1, Guole Lin1,()   

  1. 1. Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2018-07-17 Published:2019-04-25
  • Corresponding author: Guole Lin
  • About author:
    Corresponding author: Lin Guole, Email:
引用本文:

薛晓强, 林国乐. 经肛门内镜微创手术应用的新进展[J]. 中华结直肠疾病电子杂志, 2019, 08(02): 109-114.

Xiaoqiang Xue, Guole Lin. Updates on the applications and indications of the technique of transanal endoscopic microsurgery[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2019, 08(02): 109-114.

经肛门内镜微创手术(TEM)作为一项结合了内镜技术和微创手术共同优势的手术操作技术,于1983年首次与世人见面。该技术以其放大达裸眼6倍的三维手术视野,使得术者可以充分、精准地全层切除复杂的直肠病灶。此篇述评结合了国内外相关文献和笔者自身临床实践的经验,将在TEM的术前评估、传统适应证和治疗直肠疾病的创新应用上进行综述。

First introduced in the year of 1983, transanal endoscopic microsurgery (TEM) is a surgical technique that takes full advantages of both endoscopy and minimally invasive surgery. The technique allows the surgeon to excision of complex rectal lesions fully and accurately with a three-dimensional surgical view of 6 times the size of the naked eye. This article was developed on our own clinical experience and large-scale paper review to illustrate the preoperative assessment of the technique of transanal endoscopic microsurgery, as well as unveil its traditional indications and innovative applications on treating rectal diseases.

[1]
Buess G, Theiss R, Hutterer F, et al. Transanal endoscopic surgery of the rectum-testing a new method in animal experiments [J]. Leber Magen Darm, 1983, 13(2):73-77.
[2]
Buess G. Review: transanal endoscopic microsurgery (TEM) [J]. J R Coll Surg Edinb, 1993, 38(4):239-245.
[3]
Heidary B, Phang TP, Raval MJ, et al. Transanal endoscopic microsurgery: a review [J]. Can J Surg, 2014, 57(2):127-138.
[4]
Leon-Carlyle M, Brown JA, Hamm J, et al. The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery [J]. Am J Surg, 2016, 212(3):455-460.
[5]
Ashraf S, Hompes R, Slater A, et al. A critical appraisal of endorectal ultrasound and transanal endoscopic microsurgery and decision-making in early rectal cancer [J]. Colorectal Disease, 2012, 14(7):821-826.
[6]
Guerrieri M, Baldarelli M, de Sanctis A, et al. Treatment of rectal adenomas by transanal endoscopic microsurgery: 15 years′ experience [J]. Surg Endosc, 2010, 24(2):445-449.
[7]
Allaix ME, Arezzo A, Cassoni P, et al. Recurrence after transanal endoscopic microsurgery for large rectal adenomas [J]. Surg Endosc, 2012, 26(9):2594-2600.
[8]
McCloud JM, Waymont N, Pahwa N, et al. Factors predicting early recurrence after transanal endoscopic microsurgery excision for rectal adenoma [J]. Colorectal Dis, 2006, 8(7):581-585.
[9]
林国乐. 规范开展经肛门内镜显微手术[J]. 中华胃肠外科杂志, 2017, 20(8):852-856.
[10]
Arezzo A, Arolfo S, Allaix ME, et al. Transanal endoscopic microsurgery for giant circumferential rectal adenomas [J]. Colorectal Dis, 2016, 18(9):897-902.
[11]
Brown C, Raval MJ, Phang PT, et al. The surgical defect after transanal endoscopic microsurgery: open versus closed management [J]. Surg Endosc, 2017, 31(3):1078-1082.
[12]
Doornebosch PG, Zeestraten E, de Graaf EJ, et al. Transanal endoscopic microsurgery for T1 rectal cancer: size matters! [J]. Surg Endosc, 2012, 26(2):551-557.
[13]
Morino M, Allaix ME, Caldart M, et al. Risk factors for recurrence after transanal endoscopic microsurgery for rectal malignant neoplasm [J]. Surgical Endoscopy, 2011, 25(11):3683.
[14]
Hompes R, Ashraf SQ, Gosselink MP, et al. Evaluation of quality of life and function at 1 year after transanal endoscopic microsurgery [J]. Colorectal Dis, 2015, 17(2):O54-61.
[15]
Robek O, Can V, Svoboda T, et al. Transanal endoscopic microsurgery (TEM) our experience [J]. Rozhl Chir, 2016, 95(1):33-39.
[16]
Lin GL, Qiu HZ, Xiao Y, et al. Transanal endoscopic microsurgery for rectal intraepithelial neoplasia and early rectal carcinoma [J]. Chin J Gastrointest Surg, 2008, 11(1):39-43.
[17]
Kumar AS, Sidani SM, Kolli K, et al. Transanal endoscopic microsurgery for rectal carcinoids: the largest reported United States experience [J]. Colorectal Disease, 2012, 14(5):562-566.
[18]
Chen WJ, Wu N, Zhou JL, et al. Full-thickness excision using transanal endoscopic microsurgery for treatment of rectal neuroendocrine tumors [J]. World J Gastroenterol, 2015, 21(30):9142-9149.
[19]
Tielen R, Bremers AJ, van der Graaf WT, et al. Transanal endoscopic microsurgery following treatment with imatinib: a case report of a patient with a rectal gastrointestinal stromal tumor [J]. Acta Chir Belg, 2015, 115(2):166-169.
[20]
Arezzo A, Verra M, Morino M. Transanal endoscopic microsurgery after neoadjuvant therapy for rectal GIST [J]. Dig Liver Dis, 2011, 43(11):923-924.
[21]
Liu Q, Zhong G, Zhou W, et al. Initial application of transanal endoscopic microsurgery for high-risk lower rectal gastrointestinal stromal tumor after imatinib mesylate neoadjuvant chemotherapy: A case report [J]. Medicine (Baltimore), 2017, 96(29):e7538.
[22]
Chen W, Chen X, Lin G, et al. Successful repair of recurrent rectovaginal fistula by stratified suture using transanal endoscopic microsurgery: A CARE-compliant case report [J]. Medicine (Baltimore), 2016, 95(36):e4600.
[23]
Kanehira E, Tanida T, Kamei A, et al. Transanal endoscopic microsurgery for surgical repair of rectovesical fistula following radical prostatectomy [J]. Surg Endosc, 2015, 29(4):851-855.
[24]
Andrews EJ, Royce P, Farmer KC. Transanal endoscopic microsurgery repair of rectourethral fistula after high-intensity focused ultrasound ablation of prostate cancer [J]. Colorectal Disease, 2011, 13(3):342-343.
[25]
Bochove-Overgaauw DM, Beerlage HP, Bosscha K, et al. Transanal endoscopic microsurgery for correction of rectourethral fistulae [J]. J Endourol, 2006, 20(12):1087-1090.
[26]
D′Ambrosio G, Intini G, Picchetto A, et al. Treatment of recto-vesical fistula by transanal endoscopic microsurgery approach [J]. Ann Ital Chir, 2015, 86:456-458.
[27]
Sylla P, Rattner DW, Delgado S, et al. NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance [J]. Surg Endosc, 2010, 24(5):1205-1210.
[28]
Ma B, Gao P, Song Y, et al. Transanal total mesorectal excision (taTME) for rectal cancer: a systematic review and meta-analysis of oncological and perioperative outcomes compared with laparoscopic total mesorectal excision [J]. BMC Cancer, 2016, 16(1):1-13.
[29]
Simillis C, Hompes R, Penna M, et al. A systematic review of transanal total mesorectal excision: is this the future of rectal cancer surgery? [J]. Colorectal Disease, 2016, 18(1):19-36.
[30]
Fernandez-Hevia M, Delgado S, Castells A, et al. Transanal total mesorectal excision in rectal cancer: short-term outcomes in comparison with laparoscopic surgery [J]. Ann Surg, 2015, 261(2):221-227.
[31]
Rouanet P, Mourregot A, Azar CC, et al. Transanal endoscopic proctectomy: an innovative procedure for difficult resection of rectal tumors in men with narrow pelvis [J]. Dis Colon Rectum, 2013, 56(4):408-415.
[32]
Lezoche G, Baldarelli M, Guerrieri M, et al. A prospective randomized study with a 5-year minimum follow-up evaluation of transanal endoscopic microsurgery versus laparoscopic total mesorectal excision after neoadjuvant therapy [J]. Surg Endosc, 2008, 22(2):352-358.
[33]
Callender GG, Das P, Rodriguez-Bigas MA, et al. Local excision after preoperative chemoradiation results in an equivalent outcome to total mesorectal excision in selected patients with T3 rectal cancer [J]. Ann Surg Oncol, 2010, 17(2):441-447.
[34]
D′Ambrosio G, Paganini AM, Balla A, et al. Quality of life in non-early rectal cancer treated by neoadjuvant radio-chemotherapy and endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) versus laparoscopic total mesorectal excision [J]. Surgical Endoscopy and Other Interventional Techniques, 2016, 30(2):504-511.
[35]
Coco C, Rizzo G, Mattana C, et al. Transanal endoscopic microsurgery after neoadjuvant radiochemotherapy for locally advanced extraperitoneal rectal cancer: short-term morbidity and functional outcome [J]. Surgical Endoscopy and Other Interventional Techniques, 2013, 27(8):2860-2867.
[36]
Biviano I, Balla A, Badiali D, et al. Anal function after endoluminal locoregional resection by transanal endoscopic microsurgery and radiotherapy for rectal cancer [J]. Colorectal Dis, 2017, 19(6):O177-185.
[37]
Perez RO, Habr-Gama A, Sao Juliao GP, et al. Transanal Endoscopic Microsurgery (TEM) Following Neoadjuvant Chemoradiation for Rectal Cancer: Outcomes of Salvage Resection for Local Recurrence [J]. Annals of Surgical Oncology, 2016, 23(4):1143-1148.
[38]
夏立建,陈景波. 经肛门内镜微创手术(TEM)技术专家共识(2016)[J/CD]. 消化肿瘤杂志(电子版), 2016, 19(3):136-138.
[39]
Habr-Gama A, Sabbaga J, Gama-Rodrigues J, et al. Watch and wait approach following extended neoadjuvant chemoradiation for distal rectal cancer: are we getting closer to anal cancer management? [J]. Dis Colon Rectum, 2013, 56(10):1109-1117.
[40]
Serra-Aracil X, Mora-Lopez L, Alcantara-Moral M, et al. Atypical indications for transanal endoscopic microsurgery to avoid major surgery [J]. Tech Coloproctol, 2014, 18(2):157-164.
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