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Transanal endoscopic microsurgery

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https://www.readbyqxmd.com/read/29237142/transanal-endoscopic-microsurgery-for-patients-with-rare-rectal-tumors
#1
Xin Wu, Guole Lin, Huizhong Qiu, Jiaolin Zhou
BACKGROUND: Transanal endoscopic microsurgery (TEM) has been accepted worldwide for the treatment of local rectal lesions. Rare rectal tumors consist of several different types of malignant or benign tumors. Surgical management is considered to be the only curative option. The aim of this study is to investigate the role of TEM in the treatment of rare rectal tumors. MATERIALS AND METHODS: A total of 147 patients with rare rectal tumors underwent TEM in our center from April 2006 to May 2017...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29234923/non-inferiority-multicenter-prospective-randomized-controlled-study-of-rectal-cancer-t2-t3s-superficial-n0-m0-undergoing-neoadjuvant-treatment-and-local-excision-tem-vs-total-mesorectal-excision-tme
#2
X Serra-Aracil, C Pericay, T Golda, L Mora, E Targarona, S Delgado, A Reina, F Vallribera, J M Enriquez-Navascues, S Serra-Pla, J C Garcia-Pacheco
PURPOSE: The standard treatment of rectal adenocarcinoma is total mesorectal excision (TME), in many cases requires a temporary or permanent stoma. TME is associated with high morbidity and genitourinary alterations. Transanal endoscopic microsurgery (TEM) allows access to tumors up to 20 cm from the anal verge, achieves minimal postoperative morbidity and mortality rates, and does not require an ostomy. The treatment of T2, N0, and M0 cancers remains controversial. Preoperative chemoradiotherapy (CRT) in association with TEM reduces local recurrence and increases survival...
December 12, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29217973/hybrid-transanal-and-total-mesorectal-excision-after-transanal-endoscopic-microsurgery-for-unfavourable-early-rectal-cancer-a-report-of-two-cases
#3
Narimantas E Samalavičius, Audrius Dulskas, Kęstutis Petrulis, Alfredas Kilius, Renatas Tikuišis, Raimundas Lunevičius
Completion total mesorectal excision (TME) is a rare but complex procedure after transanal endoscopic microsurgery for early rectal cancer with unfavourable final histology. Two cases are reported when completion TME was performed after upfront transanal partial mesorectal dissection. Intact non-perforated TME specimens with negative and adequate distal and circumferential margins were created. The quality of both total mesorectal excisions was complete and distal margins were sufficient. We believe that our technique might be a way of approaching completion TME after TEM, especially in cases of low rectal cancer...
2017: Acta Medica Lituanica
https://www.readbyqxmd.com/read/29205758/transanal-endoscopic-microsurgery-a-new-zealand-experience
#4
Ian Bloomfield, Roelof Van Dalen, Simione Lolohea, Linus Wu
BACKGROUND: Transanal endoscopic microsurgery (TEMS) is a proven alternative therapy to either radical surgery or endoscopic mucosal resection for rectal neoplasms. It has proven benefits with lower morbidity and mortality compared with total mesorectal excision, and a lower local recurrence rate when compared to endoscopic mucosal techniques. METHODS: A retrospective data collection of TEMS procedures performed through Waikato District Health Board, New Zealand, from 2010 to 2015 was conducted...
December 3, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29184466/local-excision-and-endoscopic-resections-for-early-rectal-cancer
#5
REVIEW
Guilherme Pagin São Julião, Juan Pablo Celentano, Flavia Andrea Alexandre, Bruna Borba Vailati
Radical surgery is considered as the standard treatment for rectal cancer. Transanal local excision has been considered an interesting alternative for the management of selected patients with rectal cancers for many decades. Different approaches had been considered for local excision, from endoscopic submucosal dissection to resections using platforms, such as transanal endoscopic microsurgery or transanal minimally invasive surgery. Identifying the ideal candidate for this approach is crucial, as a local failure after local excision is associated with poor outcomes, even for an initial early rectal tumor...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29134378/organ-preservation-in-rectal-cancer-after-chemoradiation-should-we-extend-the-observation-period-in-patients-with-a-clinical-near-complete-response
#6
Britt J P Hupkens, Monique Maas, Milou H Martens, Marit E van der Sande, Doenja M J Lambregts, Stéphanie O Breukink, Jarno Melenhorst, Janneke B Houwers, Christiaan Hoff, Meindert N Sosef, Jeroen W A Leijtens, Maaike Berbee, Regina G H Beets-Tan, Geerard L Beets
BACKGROUND: To assess whether extending the observation period in patients with a near clinical complete response (near cCR) after chemoradiation (CRT) leads to an impaired oncological outcome. METHODS: Patients who had a clinical complete response (cCR) 8-10 weeks after CRT restaging with magnetic resonance imaging and endoscopy were offered a watch-and-wait strategy (W&W1), while patients with a near cCR were offered to undergo local excision or a second restaging 6-12 weeks later...
November 13, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29111832/the-use-of-antibiotics-before-transanal-endoscopic-microsurgery
#7
Andrea Balla
No abstract text is available yet for this article.
November 7, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29064849/the-outcome-of-transanal-endoscopic-microsurgery-in-obese-patients
#8
Yaniv Fenig, Mansour Khoury, Hemda Schmilovitz-Weiss, Rachel Gingold-Belfer, Gil Nissim Bachar, Nidal Issa
BACKGROUND: The prevalence of obesity is as high as one-third of the adult population in the ultrasound. Obese patients operated for rectal cancer are less likely to undergo sphincter-preserving surgery, and have an increased morbidity and mortality. We aim to report the outcomes of transanal-endoscopic-microsurgery (TEM) in obese patients with benign and malignant neoplasms. MATERIALS AND METHODS: An analysis was carried out of all patients undergoing TEM at a single institution between 2004 and 2015...
October 23, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29064311/transanal-endoscopic-microsurgery-implementation-in-ultra-low-anterior-resection
#9
Hayim Gilshtein, Mariya Neymark, Elias Manassa, Wisam Khoury, Daniel Duek
BACKGROUND: Distal rectal cancer resection is an ongoing challenge for the colorectal surgeon. In recent years new technical approaches, especially with implementation of transanal platforms were developed to help in the visualization and resection of these tumors. Nevertheless, the use of these platforms is demanding with significant complications during the onset phase. METHODS: Patients with very low rectal cancer were operated on in a single tertiary center with a combined abdominal and transanal endoscopic microsurgery (TEM) approach...
October 24, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29052070/the-feasibility-of-laparoscopic-rectal-resection-in-patients-undergoing-reoperation-after-transanal-endoscopic-microsurgery-tem
#10
M Ortenzi, R Ghiselli, A Paolucci, M Guerrieri
BACKGROUND: The success of transanal endoscopic microsurgery (TEM) for early rectal cancer depends on proper indications and strict patient selection. When unfavorable pathologic features are identified after TEM operation, total mesorectal excision is recommended to minimize the risk of recurrence. In this study, data were collected in a retrospective series of patients to determine the results of laparoscopic reoperation after TEM. METHODS: All patients underwent an accurate rectal-digital examination and clinical tumor staging by transanal endosonography, CT, and/or MRI...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29030001/the-occurrence-and-characteristics-of-endoscopically-unexpected-malignant-degeneration-in-large-rectal-adenomas
#11
Maxime E S Bronzwaer, Gijsbert D Musters, Renée M Barendse, Lianne Koens, Eelco J R de Graaf, Pascal G Doornebosch, Mathijs P Schwartz, Esther C J Consten, Erik J Schoon, Ignace H J T de Hingh, Pieter J Tanis, Evelien Dekker, Paul Fockens
INTRODUCTION: Large non-pedunculated rectal polyps are most commonly resected by endoscopic mucosal resection (EMR) or transanal endoscopic microsurgery (TEM). Despite preprocedural diagnostics, unexpected rectal cancer is incidentally encountered within the resected specimen. This study aimed to compare the diagnostic assessment and procedural characteristics of lesions with and without unexpected submucosal invasion. METHODS: A post-hoc analysis of a multicenter randomized trial (TREND study) was performed, in which patients with a non-pedunculated rectal polyp of ≥3 cm without endoscopic suspicion of invasive growth were randomized between EMR and TEM...
October 10, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28963594/transanal-endoscopic-microsurgery-for-giant-benign-rectal-tumours-is-large-size-a-contraindication
#12
Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E Samalavicius
PURPOSE: The purpose of this study is to look at our early postoperative results, recurrence rates and need for further radical surgery in treating large (> 5 cm) rectal tumours by transanal endoscopic microsurgery (TEM). METHODS: Patients who underwent TEM for rectal tumours greater than 5 cm were included. Tumour diameter was determined based on fresh specimen measurements. We recorded the demographics, operative details, final pathology, length of hospital stay, complications and recurrence rates...
December 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28905101/transanal-minimally-invasive-surgery-for-rectal-polyps-and-selected-malignant-tumors-caution-concerning-intermediate-term-functional-results
#13
S H E M Clermonts, Y T van Loon, A H W Schiphorst, D K Wasowicz, D D E Zimmerman
PURPOSE: Transanal minimally invasive surgery (TAMIS) is gaining worldwide popularity as an alternative for the transanal endoscopic microsurgery (TEMS) method for the local excision of rectal polyps and selected neoplasms. Data on patient reported outcomes regarding short-term follow-up are scarce; data on functional outcomes for long-term follow-up is non-existent. METHODS: We used the fecal incontinence severity index (FISI) to prospectively assess the fecal continence on the intermediate-term follow-up after TAMIS...
December 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28900991/-transanal-endoscopic-microsurgery-for-treatment-of-rectal-neuroendocrine-tumors
#14
Qianqian Shao, Guole Lin, Huizhong Qiu
OBJECTIVE: To assess the efficacy of full-thickness excision using transanal endoscopic microsurgery (TEM) in the treatment of rectal neuroendocrine tumors (NET). METHODS: Clinicopathological and follow-up data of 90 rectal NET patients who underwent TEM between December 2006 and December 2016 at our department were retrospectively analyzed. TEM was performed as primary excision in 66 patients and as the second complete surgery because of suspected positive margin of samples after colonoscopic polypectomy in 24 patients...
September 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28871476/peritoneal-perforation-is-less-a-complication-than-an-expected-event-during-transanal-endoscopic-microsurgery-experience-from-194-consecutive-cases
#15
D Mege, N Petrucciani, L Maggiori, Y Panis
BACKGROUND: Indications for transanal endoscopic microsurgery (TEM) have been extended to technically challenging tumors, which may be associated with an increased risk of peritoneal perforation (PP). The aim of the present study was to investigate the occurrence, management and outcome of PP in patients having TEM. METHODS: All the patients who had TEM for rectal adenoma or adenocarcinoma in our unit were included. Patients in whom PP occurred (Group A) were compared to those without PP (Group B)...
September 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28836241/-standardized-development-of-transanal-endoscopic-microsurgery
#16
Guole Lin
Transanal endoscopic microsurgery (TEM) is currently the only one-port system in endoscopic surgery, which a direct endoluminal approach can lead to the target organ through a natural opening of human body. TEM has been applied in colorectal surgery for over 3 decades. Compared with radical surgery, TEM has the advantages, such as quicker recovery, shorter hospital stay and fewer complications. One perfect TEM surgical system, which mainly consists of three parts, namely peculiar rectoscope for surgery, special surgical instruments and imaging system, is the foundation of standardized development of TEM...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28829669/clinical-values-of-preoperative-use-of-antibiotics-in-transanal-endoscopic-microsurgery
#17
Jingbo Chen, Yupeng Li, Xiangpeng Xi, Lili Qiao, Mingyu Yang, Lijian Xia, Yanbing Zhou
OBJECTIVE: To investigate the clinical values of preoperative use of antibiotics in transanal endoscopic microsurgery (TEM). METHODS: Thirty patients undergoing TEM surgery to treat rectal neoplasms in our hospital were selected in this study. All patients were randomly divided into two groups: antibiotic group that antibiotics were used before and after surgery, and control group that antibiotics were only used after surgery. Several markers were evaluated before and after surgery in all patients, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), changes procalcitonin (PCT), white blood cell count (WBC), neutrophils (NE%) and temperature (T)...
August 22, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28812153/establishing-the-learning-curve-of-transanal-minimally-invasive-surgery-for-local-excision-of-rectal-neoplasms
#18
Lawrence Lee, Justin Kelly, George J Nassif, Deborah Keller, Teresa C Debeche-Adams, Paul A Mancuso, John R Monson, Matthew R Albert, Sam B Atallah
INTRODUCTION: Transanal minimally invasive surgery (TAMIS) is an endoscopic operating platform for local excision of rectal neoplasms. However, it may be technically demanding, and its learning curve has yet to be adequately defined. The objective of this study was to determine the number of TAMIS procedures for the local excision of rectal neoplasm required to reach proficiency. METHODS AND PROCEDURES: All TAMIS cases performed from 07/2009 to 12/2016 at a single high-volume tertiary care institution for local excision of benign and malignant rectal neoplasia were identified from a prospective database...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28796731/quality-of-local-excision-for-rectal-neoplasms-using-transanal-endoscopic-microsurgery-versus-transanal-minimally-invasive-surgery-a-multi-institutional-matched-analysis
#19
MULTICENTER STUDY
Lawrence Lee, Kimberly Edwards, Iain A Hunter, John E Hartley, Sam B Atallah, Matthew R Albert, James Hill, John R Monson
BACKGROUND: There are no data comparing the quality of local excision of rectal neoplasms using transanal endoscopic microsurgery and transanal minimally invasive surgery. OBJECTIVE: The purpose of this study was to compare the incidence of tumor fragmentation and positive margins for patients undergoing local excision of benign and malignant rectal neoplasms using transanal endoscopic microsurgery versus transanal minimally invasive surgery. DESIGN: This was a multi-institutional cohort study using coarsened exact matching...
September 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28761873/pneumoretroperitoneum-and-sepsis-after-transanal-endoscopic-resection-of-a-rectal-lateral-spreading-tumor
#20
Bruno Augusto Alves Martins, Marcelo de Melo Andrade Coura, Romulo Medeiros de Almeida, Natascha Mourão Moreira, João Batista de Sousa, Paulo Gonçalves de Oliveira
Transanal endoscopic microsurgery is considered a safe, appropriate, and minimally invasive approach, and complications after endoscopic microsurgery are rare. We report a case of sepsis and pneumoretroperitoneum after resection of a rectal lateral spreading tumor. The patient presented with rectal mucous discharge. Colonoscopy revealed a rectal lateral spreading tumor. The patient underwent an endoscopic transanal resection of the lesion. He presented with sepsis of the abdominal focus, and imaging tests revealed pneumoretroperitoneum...
June 2017: Annals of Coloproctology
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