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transanal rectal cancer

Jae Hwan Oh, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jong Hee Hyun, Hee Jin Chang, Kyung Su Han, Dae Kyung Sohn
PURPOSE: To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. METHODS: This study enrolled 12 patients with clinically node negative rectal cancer located 4-12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of single port laparoscopic surgery between September 2013 and August 2014. The primary endpoint was TME quality; secondary endpoints included number of harvested lymph nodes and postoperative complications within 30 days (NCT01938027)...
October 2016: Annals of Surgical Treatment and Research
Marta Penna, Roel Hompes, Steve Arnold, Greg Wynn, Ralph Austin, Janindra Warusavitarne, Brendan Moran, George B Hanna, Neil J Mortensen, Paris P Tekkis
OBJECTIVE: This study aims to report short-term clinical and oncological outcomes from the international transanal Total Mesorectal Excision (taTME) registry for benign and malignant rectal pathology. BACKGROUND: TaTME is the latest minimally invasive transanal technique pioneered to facilitate difficult pelvic dissections. Outcomes have been published from small cohorts, but larger series can further assess the safety and efficacy of taTME in the wider surgical population...
October 4, 2016: Annals of Surgery
Wen-Tao Zhao, Ning-Ning Li, Dan He, Jin-Yan Feng
BACKGROUND: Transanal tubes (TTs) have been used to prevent and reduce anastomotic leakage after rectal cancer surgery. The aim of this review was to investigate the efficacy and safety of the TT. METHODS: A systematic literature search was performed to identify randomized controlled trials and controlled clinical trials assessing the clinical efficacy and safety of TTs in rectal cancer surgery. RESULTS: Seven trials with 1609 participants were included...
October 12, 2016: World Journal of Surgery
Young Seob Shin, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Tae Won Kim, Heung Moon Chang, Jin-Hong Park, Seung Do Ahn, Sang-Wook Lee, Eun Kyung Choi, Jin Cheon Kim, Jong Hoon Kim
PURPOSE: To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients. MATERIALS AND METHODS: Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients' characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months...
September 2016: Radiation Oncology Journal
W Xu, Z Xu, H Cheng, J Ying, F Cheng, W Xu, J Cao, J Luo
AIM: The objective of this meta-analysis was to evaluate the feasibility, safety, and short-term clinical outcomes of transanal total mesorectal excision (TaTME) comparing with laparoscopy total mesorectal excision (LapTME) for mid and low rectal cancer. METHODS: Relevant studies were searched from the databases of Pubmed, Embase, and the Cochrane Library. The qualities of all of the included studies were evaluated using Newcastle-Ottawa Scale (NOS). The synthesized outcomes were pooled using fixed-effects models or random-effects models, which weighted the odds ratio (OR) or mean difference (MD) with 95% confidence intervals (95% CI)...
September 19, 2016: European Journal of Surgical Oncology
Marta Penna, Nicolas C Buchs, Alexander L Bloemendaal, Roel Hompes
The surgical approach to total mesorectal excision (TME) for rectal cancer has undergone a substantial evolution with the adoption of more minimally invasive procedures. Transanal TME (taTME) is the latest advanced technique pioneered to tackle difficult pelvic dissections. Areas covered: The evolution of TME surgery from open to laparoscopic, robotic and transanal techniques was explored in this review. The outcomes to date on the latest approach, taTME, are reviewed and the future direction of rectal cancer surgery proposed...
October 3, 2016: Expert Review of Anticancer Therapy
Marta Penna, Mark Whiteford, Roel Hompes, Patricia Sylla
AIM: Transanal Total Mesorectal Excision (taTME) has become one of the most promising technical advancement in the surgical treatment of rectal cancer, with rising numbers of surgeons seeking training. We describe our experience with human cadaveric courses for taTME delivered in two countries. METHOD: Four fresh human cadaveric workshops conducted in Oxford, UK in 2015 and two in Chicago, USA in 2013-2014, trained a total of 52 surgeons. Parameters of operative performance for each delegate were recorded...
September 19, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Balázs Bánky, Géza Járay
Diseases of the lower and middle third of the rectum, the so called "no-man's territory" traditionally represent a major surgical problem. Minimally invasive surgical techniques significantly contribute to the safe and precise management of this part of the rectum. Traditional laparoscopic instruments via a specifically designed operative anoscope with single-port surgical technique are used during TAMIS (transanal endoscopic minimally invasive surgery). Since the description of the procedure in 2009 a number of case series have proven the feasibility and safety of the technique in the treatment of rectal adenomas...
September 2016: Magyar Sebészet
A Chau, M Frasson, C Debove, L Maggiori, Y Panis
BACKGROUND: There are no published data concerning management of patients with exteriorized colonic prolapse (CP) after intersphincteric rectal resection (ISR) and side-to-end coloanal manual anastomosis (CAA) for very low rectal cancer. The aim of the present study was to report our experience in 12 consecutive cases of CP following ISR with CAA. METHODS: From 2006 to 2014, all patients with very low rectal cancer who developed CP after ISR and CAA were reviewed...
October 2016: Techniques in Coloproctology
F Aigner, M Biebl, A Fürst, T Jöns, J Pratschke, W Kneist
BACKGROUND: In recent years the video endoscopy-assisted transanal approach to total mesorectal excision (TME) combined with the conventional laparoscopic technique was developed as an alternative indication for treatment of low rectal cancer (TaTME). OBJECTIVE: The concept and results of the first German TaTME hands-on cadaver course with subsequent live surgery are presented. MATERIAL AND METHODS: The 2‑day training course was structured into an anatomical and a clinical surgery part...
September 15, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Yun Yang, Ye Shu, Fangyu Su, Lin Xia, Baofeng Duan, Xiaoting Wu
BACKGROUND: Transanal decompression tube (TDT), an alternative intervention believed to have potential equivalent efficacy in reducing anastomotic leakage after rectal cancer surgery and lower complication rates compared to protective stoma, was sporadically applied in some medical centers during recent decade. The objective of this meta-analysis was to evaluate the effect of the TDT in preventing the anastomotic leakage after low anterior resection for rectal cancer. METHODS: The studies comparing TDT and non-TDT in rectal cancer were researched up to March 22, 2016 without language preference, in databases of PubMed, Web of Science, Cochrane library, International Clinical Trials Registry Platform, and National Clinical Trials Registry...
September 12, 2016: Surgical Endoscopy
Chun-Seok Yang, Gyu-Seog Choi, Jun Seok Park, Soo Yeun Park, Hye Jin Kim, Jong-Ik Choi, Kil Su Han
AIM: Anastomotic leakage is the most serious complication following low anterior resection (LAR) for rectal cancer and is a major cause of postoperative morbidity and mortality. The object of the present study was to investigate whether rectal tube drainage can reduce anastomotic leakage after minimally invasive rectal cancer surgery. METHOD: From April 2012 to October 2014, 374 patients who underwent laparoscopic or robotic LAR for tumours located ≤ 15 cm above the anal verge were assessed retrospectively...
September 9, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Jae-Uk Jeong, Taek-Keun Nam, Hyeong-Rok Kim, Hyun-Jeong Shim, Yong-Hyub Kim, Mee Sun Yoon, Ju-Young Song, Sung-Ja Ahn, Woong-Ki Chung
BACKGROUND: After local excision of early rectal cancer, revision radical resection is recommended for patients with high-risk pathologic stage T1 (pT1) or pT2 cancer, but the revision procedure has high morbidity rates. We evaluated the efficacy of adjuvant concurrent chemoradiotherapy (CCRT) for reducing recurrence after local excision in these patients. METHODS: Eighty-three patients with high-risk pT1 or pT2 rectal cancer underwent postoperative adjuvant CCRT after local excision...
2016: Radiation Oncology
Silvia Quaresima, Andrea Balla, Luana Franceschilli, Marco La Torre, Corrado Iafrate, Mostafa Shalaby, Nicola Di Lorenzo, Pierpaolo Sileri
BACKGROUND AND OBJECTIVES: Transanal minimally invasive surgery (TAMIS) has emerged as an alternative to transanal endoscopic microsurgery (TEM). The authors report their experience with TAMIS for the treatment of mid and high rectal tumors. METHODS: From November 2011 through May 2016, 31 patients (21 females, 68%), with a median age of 65 years who underwent single-port TAMIS were prospectively enrolled. Mean distance from the anal verge of the rectal tumors was 9...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Liang Kang, Shuangling Luo, Wenhao Chen, Xinwei Zhang, Yonghua Cai, Yujie Hou, Huanxin Hu, Jianping Wang
OBJECTIVE: To explore the learning curve of transanal total mesorectal excision (taTME) for rectal cancer. METHODS: Clinical data of 60 rectal cancer patients undergoing taTME from July 2014 to April 2016 were retrospectively analyzed. According to the sequence of operation date, 60 patients were divided into four groups (A, B, C, D) with 15 cases in each group. General information and perioperative, especially the operative indexes were compared among four groups...
August 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Liang Kang, Jianping Wang
Since the characteristics of metastasis and invasion of rectal cancer are confirmed gradually, the aim of surgical treatment in rectal cancer is to protect anal and reproductive function, and to minimize the damage of patients. With prominent advantages of identified lower tumor resection margin, enough circumference resection margin, more minimally invasive procedure and faster recovery, transanal total mesorectal excision(taTME) integrated with natural canal theory, transanal minimally invasive technique and TME can effectively solve the difficulties of transabdominal procedure and becomes the research hotspot in rectal cancer surgery worldwide...
August 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Minhua Zheng, Junjun Ma
With the development in past 20 years, the utilization of the laparoscopic surgery, which is the main trend in minimally invasive surgery for colorectal cancer, has tremendously changed. Minimally invasive surgery for colorectal cancer is now at a high level platform after going through the exploration at the very beginning and rapid development in the period of standardizing and promoting the regulations. Nowadays, the unique advantage that the laparoscopy owns is high definition and enlargement of the image, along with the establishment of the key note in series of laparoscopic complete mesocolic excision and the improvement of surgical instruments and methods make the operation skills accurate and normative in exploration of correct plane, high ligation of vessels and protection of nerve during the lymph node dissection of colorectal surgery...
August 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Milou H Martens, Monique Maas, Luc A Heijnen, Doenja M J Lambregts, Jeroen W A Leijtens, Laurents P S Stassen, Stephanie O Breukink, Christiaan Hoff, Eric J Belgers, Jarno Melenhorst, Rob Jansen, Jeroen Buijsen, Ton G M Hoofwijk, Regina G H Beets-Tan, Geerard L Beets
BACKGROUND: The aim of this study was to establish the oncological and functional results of organ preservation with a watch-and-wait approach (W&W) and selective transanal endoscopic microsurgery (TEM) in patients with a clinical complete or near-complete response (cCR) after neoadjuvant chemoradiation for rectal cancer. METHODS: Between 2004 and 2014, organ preservation was offered if response assessment with digital rectal examination, endoscopy, and MRI showed (near) cCR...
December 2016: Journal of the National Cancer Institute
Hideaki Nishigori, Masaaki Ito, Yuji Nishizawa
PURPOSE: We introduce a novel transanal tube (TAT), named the "WING DRAIN", designed to prevent anastomotic leakage after rectal cancer surgery, and report the fundamental experiments that led to its development. MATERIALS AND METHODS: We performed the basic experiments to evaluate the effect of TATs on intestinal decompression, the changes they make in patterns of watery fluid drainage, the changes in their decompression effect when the extension tube connecting the TAT to the collection bag fills with watery drainage fluid, and the variations in intestinal contact and crushing pressure made by some types of TAT...
August 9, 2016: Surgery Today
Ivana Fratrić, Zoran Radovanović, Dragana Radovanović, Ferenc Vicko, Tomislav Petrović, Zoran Nikin
INTRODUCTION: Anastomotic leakage is the most serious surgical complication in rectal surgery. The aim of this study was to find out whether a protective stoma was capable of lowering the rate of clinical anastomotic leakage and to evaluate the rate of anastomotic leakages requiring resurgery. MATERIAL AND METHODS: A retrospective study included a sample of 149 consecutive patients with rectal cancer who had undergone elective rectal resection with primary anastomosis...
March 2016: Medicinski Pregled
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