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https://www.readbyqxmd.com/read/29791978/combination-of-endoscopic-submucosal-dissection-and-transanal-minimally-invasive-surgery-for-the-resection-of-early-rectal-cancer-with-fibrosis-after-prior-partial-excision
#1
Sung Hoo Kim, Dong Hoon Yang, Seok-Byung Lim
Endoscopic submucosal dissection is an effective procedure for treating non-invasive colorectal tumors. However, in cases of severe fibrosis, endoscopic submucosal dissection may be technically difficult, leading to incomplete resection. Here, we describe the case of a 74-year-old man who had early rectal cancer along with severe submucosal fibrosis caused by prior local excision. Combination treatment with endoscopic submucosal dissection and transanal minimally invasive surgery successfully enabled complete resection...
May 23, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29791891/transanal-endoscopic-microsurgery-with-or-without-completion-total-mesorectal-excision-for-t2-and-t3-rectal-carcinoma
#2
Jeroen W A Leijtens, Thomas W A Koedam, Wernard A A Borstlap, Monique Maas, Pascal G Doornebosch, Tom M Karsten, Eric J Derksen, Laurents P S Stassen, Camiel Rosman, Eelco J R de Graaf, André J A Bremers, Jeroen Heemskerk, Geerard L Beets, Jurriaan B Tuynman, Kevin L J Rademakers
AIM: Transanal endoscopic microsurgery (TEM) is used for the resection of large rectal adenomas and well or moderately differentiated T1 carcinomas. Due to difficulty in preoperative staging, final pathology may reveal a carcinoma not suitable for TEM. Although completion total mesorectal excision is considered standard of care in T2 or more invasive carcinomas, this completion surgery is not always performed. The purpose of this article is to evaluate the outcome of patients after TEM-only, when completion surgery would be indicated...
May 23, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29790661/transanal-minimally-invasive-surgery-as-a-treatment-option-for-a-completely-occluded-anastomosis-after-low-anterior-resection-a-new-approach-to-severe-anastomotic-stenosis
#3
Jun Woo Bong, Seok-Byung Lim
New techniques have been developed to treat severe anastomotic strictures after rectal surgery. This report describes a new approach using transanal minimally invasive surgery for the treatment of complete anastomotic occlusion. A 49-year-old man presented with a completely occluded anastomosis after low anterior resection with temporary ileostomy for rectal cancer. The lumen was completely obstructed with a blind wall. A transanal surgical approach was used to treat the obstruction. Water-soluble radiopaque contrast medium was injected intraoperatively to identify the proximal lumen, and an incision was made by electrocautery until the luminal diameter was sufficient...
May 23, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29789768/radiological-and-clinical-findings-following-rectal-contact-x-ray-brachytherapy-papillon-technique-how-to-assess-response
#4
Matt J D Dunstan, Tim A Rockall, Kate Potter, Alexandra J Stewart
Purpose: Rectal contact X-ray brachytherapy (Papillon radiotherapy) has recently received approval from the National Institute for Health and Care Excellence. In particular, it is suitable for elderly patients who are high-risk for a major operation, but it may also be undertaken for patients who wish to avoid a stoma. It is imperative to be able to identify clinical response or tumor regrowth on surveillance magnetic resonance imaging (MRI) and sigmoidoscopy. This article aims to help clinicians to interpret MRIs and endoscopic appearances following Papillon radiotherapy...
April 2018: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/29777788/modified-transanosphincteric-york-mason-repair-of-non-radiated-rectourinary-fistulae-patient-reported-fecal-continence-outcomes
#5
Maxim J McKibben, Joceline S Fuchs, Alexander T Rozanski, Jeremy M Scott, Craig Olson, Farshid Araghizadeh, Allen F Morey
OBJECTIVES: To review our experience with the modified York Mason (MYM) procedure in treatment of rectourinary fistulae (RUF), and to assess fecal continence using patient reported measures. METHODS: Retrospective review was performed for patients who underwent MYM repair of non-radiated RUF with gluteal free fat graft from 2008 to 2016 at a single institution. Success was defined as resolution of fistula without need for further surgery. The Cleveland Clinic-Florida Wexner Fecal Incontinence Score (CCFFIS) and Patient Global Impression of Improvement (PGI-I) surveys were administered by phone...
May 16, 2018: Urology
https://www.readbyqxmd.com/read/29776947/rectal-mucocele-in-the-anterior-wall-of-the-rectum
#6
Daisuke Ishii, Takanori Aoki, Satoshi Inaba, Hidehiko Yabuki
An 84-year-old man presented in 2009 with a sensation of discomfort in his anus, combined with difficulty in urination. He had previously undergone a haemorrhoidectomy in 1964. After examination, he was diagnosed with a rectal mucosal cyst and followed up for observation. In 2015, he presented to our hospital complaining that the cyst was prolapsing from his anus. CT revealed a 48×41 mm cystic mass in the anterior wall of the rectum. Tumour extirpation, via a transanal route, was performed. The postoperative pathological diagnosis confirmed a rectal mucocele...
May 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29776939/outcomes-of-transanal-endorectal-pull-through-for-rectal-atresia
#7
Mutaz Gieballa, Nawaf AlKharashi, Mohammed Al-Namshan, Saud AlJadaan
Rectal atresia is a rare anorectal malformation, and it has been reported to represent 1%-2% of all anorectal malformations. We report three newborns who were admitted to the neonatal intensive care unit for abdominal distention, bilious vomiting and failure to pass meconium. The external anus and genitalia were normal and well formed. Digital rectal examination showed a blind-ending anal canal. All three infants were initially managed with diverting colostomy and then transanal resection of the rectal atresia with primary anastomosis, followed by colostomy closure...
May 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29771810/transanal-total-mesorectal-excision-vs-laparoscopic-total-mesorectal-excision-in-the-treatment-of-low-and-middle-rectal-cancer-a-propensity-score-matching-analysis
#8
Roberto Persiani, Alberto Biondi, Francesco Pennestrì, Valeria Fico, Veronica De Simone, Flavio Tirelli, Francesco Santullo, Domenico D'Ugo
BACKGROUND: Transanal total mesorectal excision is a novel and promising technique in the treatment of low and middle rectal cancer. OBJECTIVE: This study aimed to compare the safety and feasibility of transanal total mesorectal excision versus laparoscopic total mesorectal excision. DESIGN: This was a retrospective study using propensity score matching analysis. SETTINGS: This study was conducted in a single high-volume university hospital...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29771806/supine-bottom-up-extralevator-abdominoperineal-excision-with-primary-perineal-approach
#9
Cécile de Chaisemartin, Diane Mège, Jean Michel Durey, Hélène Meillat, Jean Robert Delpero, Bernard Lelong
To improve poor oncological outcomes of conventional abdominoperineal excision (APE), an extralevator abdominoperineal excision has been developed. This technique is associated with a larger pelvic floor defect and needs position changing and flap reconstruction, which increase operating time and morbidity without proof of best oncological results. Based on the recent development of transanal approaches for retrograde transanal mesorectal excision, we describe a novel approach for APE by a primary perineal dissection...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29767285/endoscopic-submucosal-injection-a-novel-technique-facilitating-dissection-in-transanal-minimally-invasive-surgery-tamis
#10
Y M Ho, A Mishra, N Ward
No abstract text is available yet for this article.
May 16, 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29762145/a-succinct-critical-appraisal-of-indications-to-transanal-total-mesorectal-excision
#11
Mahir Gachabayov, Alexandra Chudner, Roberto Bergamaschi
No abstract text is available yet for this article.
May 14, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29740919/transanal-total-mesorectal-excision-for-locally-advanced-pt4b-rectal-cancers
#12
Chun Han Nigel Tan, Kuok Chung Lee, Wai Kit Cheong, Choon Seng Chong
No abstract text is available yet for this article.
May 8, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29725785/salvage-tme-following-tem-a-possible-indication-for-tatme
#13
F Letarte, M Raval, A Karimuddin, P T Phang, C J Brown
BACKGROUND: Salvage surgery after transanal endoscopic microsurgery (TEM) has shown mixed results. Transanal total mesorectal excision (TaTME) might be advantageous in this population. The aim of this study was to assess the short-term oncologic and operative outcomes of salvage surgery after TEM, comparing TaTME to conventional salavge TME (sTME). METHODS: Consecutive patients treated with salvage surgery after TEM were identified. Patients who underwent TaTME were compared to those who had conventional sTME...
May 4, 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29725436/a-small-well-differentiated-rectal-neuroendocrine-tumor-with-multiple-lymph-node-metastases-a-case-report
#14
Seung-Joo Nam, Gi Bong Chae, Seungkoo Lee, Sung Chul Park, Chang Don Kang, Sung Joon Lee
The incidence of rectal neuroendocrine tumor (NET), which is often diagnosed during routine surveillance endoscopy, is increasing. The majority of these tumors are small and asymptomatic, possessing benign features with favorable prognoses. At present, small rectal NETs without high-risk factors are typically treated by local resection, including endoscopic mucosal resection, endoscopic submucosal dissection, or transanal endoscopic microsurgery, with or without additional imaging follow-up by abdominal computed tomography or magnetic resonance imaging...
May 2018: Oncology Letters
https://www.readbyqxmd.com/read/29724664/cognitive-skills-training-in-digital-era-a-paradigm-shift-in-surgical-education-using-the-tatme-model
#15
REVIEW
Joep Knol, Deborah S Keller
Surgical competence is a complex, multifactorial process, requiring ample time and training. Optimal training is based on acquiring knowledge and psychomotor and cognitive skills. Practicing surgical skills is one of the most crucial tasks for both the novice surgeon learning new procedures and surgeons already in practice learning new techniques. Focus is placed on teaching traditional technical skills, but the importance of cognitive skills cannot be underestimated. Cognitive skills allow recognizing environmental cues to improve technical performance including situational awareness, mental readiness, risk assessment, anticipating problems, decision-making, adaptation, and flexibility, and may also accelerate the trainee's understanding of a procedure, formalize the steps being practiced, and reduce the overall training time to become technically proficient...
April 30, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29717372/combined-repeat-laparoscopy-and-transanal-endolumenal-repair-hybrid-approach-in-the-early-management-of-postoperative-colorectal-anastomotic-leaks-technique-and-outcomes
#16
William Tzu-Liang Chen, Saurabh Bansal, Tao-Wei Ke, Sheng-Chi Chang, Yu-Chun Huang, Takashi Kato, Hwei-Ming Wang, Abe Fingerhut
BACKGROUND: Few clear recommendations exist for the management of colorectal anastomotic leaks, often based on surgeon preferences or institutional protocols. The primary goal was to evaluate the feasibility and safety of the combined laparoscopic and transanal (hybrid) approach to treat postoperative colorectal anastomotic leaks. The secondary goals included comparison of outcomes following early (< 5 days after initial resection) versus late (≥ 5 days) detection of leaks...
May 1, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29709273/how-to-deal-with-rectal-lesions-more-than-15-cm-from-the-anal-verge-through-transanal-endoscopic-microsurgery
#17
Xavier Serra-Aracil, Raquel Gràcia, Laura Mora-López, Sheila Serra-Pla, Anna Pallisera-Lloveras, Maritxell Labró, Salvador Navarro-Soto
BACKGROUND: The aim of this study is to assess postoperative morbidity and mortality in tumors with a proximal margin 15 cm or more from the anal verge operated with transanal endoscopic microsurgery (TEM). METHODS: This observational study of consecutive rectal tumor patients undergoing TEM was carried out from July 2004 to June 2017. We compared the results of rectal tumors at distances of ≥15 cm (group A) and <15 cm (group B) from the anal verge. RESULTS: During the study period 667 patients were included: 118 in group A and 549 in group B...
April 22, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29694306/totally-laparoscopic-resection-and-extraction-of-specimens-via-transanal-route-in-synchronous-colon-and-gastric-cancer
#18
F Sumer, S Karakas, E Gundogan, T Sahin, C Kayaalp
INTRODUCTION: Synchronous colon and gastric cancer is a rare clinical entity. In the present case, it is aimed to show that in a patient with synchronous colon and gastric cancer, laparoscopic resection can be safely performed and both specimens can be delivered through a natural orifice. In our knowledge, this is the first example showing the delivery of the gastric resection specimen through the anus in a human being. CASE REPORT: Sixty-six years old male patient with an upper gastrointestinal bleeding and obstruction symptoms was admitted to our department and the evaluation revealed an advanced stage gastric and a synchronous colon cancer...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29685761/impact-of-an-institutional-change-from-routine-to-highly-selective-diversion-of-a-low-anastomosis-after-tme-for-rectal-cancer
#19
R D Blok, R Stam, E Westerduin, W A A Borstlap, R Hompes, W A Bemelman, P J Tanis
INTRODUCTION: The need for routine diverting ileostomy following restorative total mesorectal excision (TME) is increasingly debated as the benefits might not outweigh the disadvantages. This study evaluated an institutional shift from routine (RD) to highly selective diversion (HSD) after TME surgery for rectal cancer. MATERIALS AND METHODS: Patients having TME with primary anastomosis and HSD for low or mid rectal cancer between December 2014 and March 2017 were compared with a historical control group with RD in the preceding period since January 2011...
April 12, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29682708/-early-diagnosis-and-treatment-of-anastomotic-leak-after-rectal-cancer-surgery
#20
Tinghan Yang, Ziqiang Wang
Anastomotic leakage is the most common major complication after mid-low rectal cancer surgery. Due to lack of knowledge regarding the virtual mechanisms of anastomotic leakage, not much can be done to prevent its development. The aim of the present review was to discuss the prevention, early diagnosis, and treatment of anastomotic leakage after rectal cancer surgery. For patients with risk factors, such as anastomotic site within 4 cm from anus, obese men, lack of blood supply of the anastomotic site, neoadjuvant chemo radiotherapy, or patients with severe co-morbidity, aggressive preventive strategy should be adopted...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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