| 特集名 | 大きな(2cm以上)ポリープの取扱い --内視鏡治療の適応と手技 | |
|---|---|---|
| 題名 | 治療手技(適応も含む) (3) 経肛門的内視鏡下マイクロサージェリー(TEM)の立場から | |
| 発刊年月 | 2000年 11月 | |
| 著者 | 金平 永二 | 金沢大学医学部第一外科 |
| 著者 | 大村 健二 | 金沢大学医学部第一外科 |
| 著者 | 石田 善敬 | 金沢大学医学部第一外科 |
| 著者 | 石黒 要 | 金沢大学医学部第一外科 |
| 著者 | 前田 一也 | 金沢大学医学部第一外科 |
| 著者 | 渡辺 剛 | 金沢大学医学部第一外科 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Management of large colorectal polyp --Indication and technique of endoscopic treatment | |
|---|---|---|
| Title | From the stand point of transanal endoscopic microsurgery (TEM) | |
| Author | Eiji Kanehira | 1st Department of Surgery, Kanazawa University School of Medicine |
| Author | Kenji Omura | 1st Department of Surgery, Kanazawa University School of Medicine |
| Author | Yoshinori Ishida | 1st Department of Surgery, Kanazawa University School of Medicine |
| Author | Kaname Ishiguro | 1st Department of Surgery, Kanazawa University School of Medicine |
| Author | Kazuya Maeda | 1st Department of Surgery, Kanazawa University School of Medicine |
| Author | Go Watanabe | 1st Department of Surgery, Kanazawa University School of Medicine |
| [ Summary ] | Transanal endoscopic microsurgery (TEM) is performed with the specially developed operating rectoscope for local resection of rectal tumors. TEM is indicated for rectal lesions such as sessile villous tumors, mucosal carcinomas, and carcinoid tumors. In comparison with EMR, TEM has many merits. TEM enables large en bloc resection of the rectal wall in any sizes, shapes, or depth. Moreover defects in the rectal wall can be closed by suturing during TEM. Among our experience in 100 TEM cases 27 patients with rectal tumors, diagnosed to be adenoma preoperatively, measuring larger than 2cm in diameter, were reviewed and analyzed. The tumor size ranged from 2.0 to 8.5cm, with an average of 3.85cm. Postoperatively, 13 tumors (48%) turned out to be cancer in adenoma. En bloc resection was carried out in 24 cases (89%). The surgical margin was tumor positive in only one case. No significant operative complications were observed. During the follow up period, for a maximum of 4.8 years with an average of 1.8 years, there was only one case of local recurrence. We concluded that TEM is an excellent, minimally invasive modality for local rectal resection, contributing to higher quality for of the patients. |
|