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  • 1 Semmelweis Egyetem II. Sz. Patológiai Intézet Budapest
  • | 2 Semmelweis Egyetem I. Sz. Sebészeti Klinika 1082 Budapest Üllői út 78.
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A rectum középső és alsó harmada válogatott daganatainak ellátására kifejlesztett transanalis endoscopos mikrosebészeti (TEM) eljárás alacsony recidíva- és szövődményrátájú, így a hagyományos műtéti technikák alternatívája lehet, ha az onkológiai radikalitás szempontjából nem jelent kompromisszumot. A TEM-eljárás 2013 őszétől érhető el – Magyarországon második centrumként, de jelenleg a legkorszerűbb felszereltségű − a Semmelweis Egyetem I. Sz. Sebészeti Klinikáján. Jelen vizsgálatunkban célul tűztük ki, hogy az utóbbi egy év klinikopatológiai adatait elemezzük. 2013. szeptember és 2014. szeptember között TEM-technikával operált betegek adatait elemeztük retrospektív módon. 44 beteg került TEM-eljárással ellátásra rectumneoplasia miatt. Szövettani vizsgálattal az elváltozások között 12 low grade adenoma, 14 high grade adenoma, 17 invasiv adenocarcinoma és 1 neuroendokrin tumor volt. A low grade és high grade adenomák, illetve adenocarcinomák mérete között nem tudtunk szignifikáns különbséget kimutatni (p = 0,210). A 30 mm alatti és feletti elváltozások között a szövettani diagnózisok tekintetében szignifikáns különbséget nem tapasztaltunk (p = 0,424). A 44 esetből 13 esetben a praeoperativ szövettani vizsgálat kedvezőbb prognózisú elváltozást jelzett, mint a TEM-excisiós preparátumon végzett végleges szövettani elemzés (p < 0,001). A szövettani vizsgálat 41 esetben (95,3%) igazolta az épben történő kimetszést. Mindazonáltal a több darabban vagy mucosectomiával történő polypectomia – különösen nagyméretű adenomák esetében – nem tekinthető elegendő kezelésnek, ezért – más kutatócsoportokhoz hasonlóan – javasoljuk a TEM-technikával a teljes rectumfalra kiterjedő excisiót. A pT2 stádiumú daganatok esetében a választandó eljárás tekintetében a jelenleg is zajló prospektív klinikai vizsgálatok fognak bizonyosságot adni.

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Editor(s)-in-Chief: Oláh, Attila

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  • DR. BÁLINT ANDRÁS
  • DR. BEZSILLA JÁNOS
  • DR. BOROS MIHÁLY
  • DR. BURSICS ATTILA
  • DR. DAMJANOVICH LÁSZLÓ
  • DR. ENTZ LÁSZLÓ
  • DR. GULYÁS GUSZTÁV
  • DR. HARSÁNYI LÁSZLÓ
  • DR. HORVÁTH ÖRS PÉTER
  • DR. ISTVÁN GÁBOR
  • DR. KECSKÉS LÁSZLÓ
  • DR. KÓBORI LÁSZLÓ
  • DR. KUPCSULIK PÉTER
  • DR. LÁZÁR GYÖRGY
  • DR. LESTÁR BÉLA
  • DR. MÁTRAI ZOLTÁN
  • DR. MOHOS ELEMÉR
  • DR. MOLNÁR F. TAMÁS
  • DR. ONDREJKA PÁL
  • DR. PAPP ANDRÁS
  • DR. RÉNYI-VÁMOS FERENC
  • DR. ROMICS LÁSZLÓ JR.
  • DR. SÓTONYI PÉTER
  • DR. SZIJÁRTÓ ATTILA
  • DR. SZŰCS ÁKOS
  • DR. VEREBÉLY TIBOR
  • DR. VERECZKEI ANDRÁS

Petz Aladár County Teaching Hospital, Surgery
Vasvári Pál út 2. H-9024 Győr, Hungary
Phone: +36 96 503 320 --- Fax: +36 96 507 936
E-mail: olaha@petz.gyor.hu

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Magyar Sebészet
Language Hungarian
Size B5
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1947
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2021 Volume 74
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