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目的：探讨经肛门内镜显微手术（transanal endoscopic microsurgery，TEM）治疗直肠肿瘤的临床疗效。方法：分析总结唐山市人民医院于2014年2月至2014年8月诊治20例 TEM患者，对其术中出血、术后出血、术后感染、术后大便失禁等并发症及平均住院时间等来评价其临床疗效。结果：20例 TEM患者均获得肿瘤的完整切除，其中14例为绒毛管状腺瘤，合并3例为伴高级别上皮内瘤变，4例为高分化腺癌，2例为直肠类癌。术后标本切缘病理均为阴性，术中出血均＜10ml，术后未出现出血、大便失禁、感染等并发症，5例患者术后第1天出现轻微肛门疼痛不适，给予对症处理后，术后第二天缓解。平均住院时间为4．5天。结论：经肛门内镜显微手术（TEM）对于治疗直肠肿瘤是一种安全可行、有效的术式，具有较好的临床疗效。","Objective:To evaluate the clinical ef icacy of transanal endoscopic microsurgery (TEM)for rectal tumors.Methods:Data from the twenty patients who received TEMoperation between February 2014 and August2014 in Tangshan People's Hospital,which were analyzed and summarized to evaluate clinical ef icacy in complications including bleed loss,postoperative bleed-ing,postoperative infection ,fecal incontinence and the average time of hospitalization.Results:Al the patients’tumor were removed completely by TEM,during the tewnty cases,fourteen cases were vil ousa -tubular adenomas,three cases were high grade intraepithelial neoplasia ,four cases were high dif erentiated adenocarcinoma and two cases were rectal carcinoid.According to the pathological,al margins were negative.The bleeding was less than 10ml.Postoperative bleeding,fecal incontinence,infections and other complications did not appear on.There were five patients appeared mild pain and discomfort for their anal after operating.Given symptomatic treatment ,the patients have relieved after the second day.The postoperative average hospital stay was 4.5 days.Conclusion:TEMis a safe and ef ective surgical approach,which is provided with bet er clinical results for the treatment of rectal tumors.