Indications and Techniques of Transanal Endoscopic Microsurgery (TEMS)
Indications and Techniques of Transanal Endoscopic Microsurgery (TEMS)
复制标题
经肛门内窥镜显微手术 (TEMS) 的适应症和技术
DOI：
10.1007/s11605-011-1576-9
复制
发表时间：
2011
影响因子：
3.2
通讯作者：
J. Monson
中科院分区：
文献类型：
--
作者：
Y. Qi;D. Stoddard;J. Monson
经肛门内镜显微手术（TEMS）最近重新成为一种有价值的技术，用于治疗直肠肿瘤-良性和恶性。自20世纪80年代初首次描述该技术以来，TEMS已成为大多数良性直肠肿瘤的首选入路，因为与传统经肛切除术相比，TEMS提供了良好的视野和上级解剖技术。许多已发表的报告表明，TEMS的复发率最低，这可能是因为全层切除的阴性边缘。TEMS越来越多地被应用于原发性直肠癌，当单独使用时，作为单独的全层切除或与其他治疗相结合，这取决于肿瘤的分期。现在有一个重要的证据基础表明，这种方法应被视为直肠癌多学科方法的一部分。本文介绍了该技术的适应症和技术。
Transanal endoscopic microsurgery (TEMS) has recently reemerged as a valuable technique for the management of rectal neoplasms — both benign and malignant. Since the original description of this technique in the early 1980s, TEMS has emerged as the approach of choice for most benign rectal tumors because of the excellent views provided and superior dissection techniques possible when compared to traditional transanal excision. Many published reports demonstrate that the lowest rates of recurrence are associated with TEMS probably because of full-thickness excision with negative margins. Increasingly, TEMS is being applied to primary rectal cancer when used alone as a full-thickness excision alone or in combination with additional therapies, depending on tumor stage. There is now a significant evidence base to suggest that this approach should be considered as part of a multidisciplinary approach to rectal cancer. This paper describes indications and techniques for this technology.