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目的:探讨经骶尾入路经肛门括约肌直肠切除术(Mason手术)治疗中低位直肠绒毛状腺瘤的应用价值。方法:回顾性分析1994年8月至2007年12月经Mason手术治疗的35例中低位直肠绒毛状腺瘤患者的临床资料。结果:全组中直肠绒毛状腺瘤26例,直肠绒毛状腺瘤癌变9例(局限于黏膜内4例、浸润黏膜下3例、浅肌层2例)。行直肠壁部分切除24例,直肠节段切除11例。术后74.3%病例近期出现不全性肛门失禁,均能在14～20d恢复正常;出现伤口积液2例(5.7%)、直肠皮肤瘘2例(5.7%)、局部复发2例(5.7%)。结论:Mason手术具有术野显露直观、手术操作空间大、病灶切除彻底、手术安全性高、便于病理分期等优点,尤其适用于可行局部切除治疗的中低位直肠绒毛状腺瘤。
Objective: To investigate the value of transnasal sacro-sphincter rectal resection (Mason operation) in the treatment of low and middle rectal villous adenoma. Methods: The clinical data of 35 patients with low and middle rectal villous adenoma treated by Mason surgery from August 1994 to December 2007 were analyzed retrospectively. Results: Twenty - six cases of rectal villous adenoma and 9 cases of rectal villous adenoma were localized in the mucosa, three in the submucosa and two in the superficial myometrium. Rectal wall partial resection in 24 cases, rectal segmental resection in 11 cases. In 74.3% of the cases, incomplete anus incontinence occurred within 14-20 days. Two cases (5.7%) had wound fluid, two cases (5.7%) had rectal fistula, and two cases (5.7%) had local recurrence. . CONCLUSION: Mason surgery possesses the advantages of intuitive surgery field, large operation space, thorough resection of the lesion, high operation safety and easy staging of the pathology. It is especially suitable for middle and low rectal villous adenoma in local excision.