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Transanal surgery

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
Li-Jen Kuo, James Chi-Yong Ngu, Yiu-Shun Tong, Chia-Che Chen
OBJECTIVE: Robot-assisted rectal surgery is gaining popularity, and robotic single-site surgery is also being explored clinically. We report our initial experience with robotic transanal total mesorectal excision (R-taTME) and radical proctectomy using the robotic single-site plus one-port (R-SSPO) technique for low rectal surgery. METHODS: Between July 2015 and March 2016, 15 consecutive patients with ultra-low rectal lesions underwent R-taTME followed by radical proctectomy using the R-SSPO technique by a single surgeon...
October 15, 2016: International Journal of Colorectal Disease
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
D A Khubezov, S N Trushin, K V Puchkov, D K Puchkov, A Yu Ogorel'tsev
AIM: to present the results of treatment of rectal foreign bodies. MATERIAL AND METHODS: 15-year outcomes of 112 patients with rectal foreign bodies were analyzed. RESULTS: Outpatient and hospital care were applied in 52 (46%) and 60 (54%) of cases respectively. Transanal removal was made in 97 (87%) patients including 28 (25%) cases of general anaesthesia. 14 (13%) patients underwent surgery. Colostomy was performed in 7 (6%) cases. We presented cases of foreign bodies removal through laparotomy, colotomy and SILS-assisted transanal approach...
2016: Khirurgiia
Kiryu Yap, Sarah Mills, Michelle Thomas, James Moore
BACKGROUND: To establish the incidence of unsuspected malignancy in lesions excised through transanal endoscopic microsurgery (TEM) and examine the justification for full-thickness excision of all lesions thought to be benign pre-operatively. METHODS: Demographic, operative and pathology data of all patients undergoing TEM at a single institution were collected in a prospectively maintained database. Follow-up data were collected with a focus on polyp recurrence rates and outcome in patients found to harbour malignancy...
October 9, 2016: ANZ Journal of Surgery
M-P Bernardi, A L A Bloemendaal, M Albert, M Whiteford, A R L Stevenson, R Hompes
PURPOSE: Transanal total mesorectal excision (taTME) requires specific technical expertise, as it is often difficult to ascertain the correct dissection plane. Consequently, one can easily enter an incorrect plane, potentially resulting in bleeding (sidewall or presacral vessels), autonomic nerve injury and urethral injury. We aim to demonstrate specific visual features, which may be encountered during surgery and can guide the surgeon to perform the dissection in the correct plane. METHOD: Specific features of dissection in the correct and incorrect planes are demonstrated in the accompanying video...
October 1, 2016: Techniques in Coloproctology
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
Giancarlo D'Ambrosio, Gianfrancesco Intini, Andrea Balla, Silvia Quaresima, Andrea Picchetto, Ardit Seitaj, Salvatore Campo, Francesca De Laurentis, Alessandro M Paganin
AIM: Recto-Urinary Fistula (RUF) is a rare complication of pelvic surgery. Different approaches are reported in literature but a gold standard treatment has not yet been achieved. Transanal Endoscopic Microsurgery (TEM) is a miniinvasive approach with well known advantages as magnification, 3D view and lighting of the operative field. Aim of the present review is to report the current evidence in literature about technique and results of RUF treatment by TEM and to suggest some key points for its correct management...
2016: Annali Italiani di Chirurgia
Wei-Cheng Liu, Song-Lin Wan, S M Yaseen, Xiang-Hai Ren, Cui-Ping Tian, Zhao Ding, Ken-Yan Zheng, Yun-Hua Wu, Cong-Qing Jiang, Qun Qian
Obstructed defecation syndrome (ODS) is a functional disorder commonly encountered by colorectal surgeons and gastroenterologists, and greatly affects the quality of life of patients from both societal and psychological aspects. The underlying anatomical and pathophysiological changes of ODS are complex. However, intra-rectal intussusception and rectocele are frequently found in patients with ODS and both are thought to play an important role in the pathogenesis of ODS. With the development of evaluation methods in anorectal physiology laboratories and radiology studies, a great variety of new operative procedures, especially transanal procedures, have been invented to treat ODS...
September 21, 2016: World Journal of Gastroenterology: WJG
Akihisa Matsuda, Masao Miyashita, Satoshi Matsumoto, Nobuyuki Sakurazawa, Goro Takahashi, Takeshi Matsutani, Marina Yamada, Eiji Uchida
BACKGROUND: The short-term safety and efficacy of a self-expandable metallic colonic stent (SEMS) insertion followed by elective surgery, "bridge to surgery (BTS)", for malignant large-bowel obstruction (MLBO) have been well described comparing with emergency surgery. The aim of this study was to compare short-term outcomes of endoscopic decompression using a SEMS versus a transanal decompression tube (TDT). MATERIALS AND METHODS: From January 2005 to November 2014, a total of 101 patients with MLBO underwent surgery at our single institution were retrospectively identified...
October 2016: Journal of Surgical Research
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
Weijie Chen, Xin Chen, Guole Lin, Huizhong Qiu
BACKGROUND: Rectovaginal fistulas (RVFs) are abnormal connections between the rectum and vagina. Although many surgical approaches to correct them have been attempted, management of RVFs still remains a challenge, especially for recurrent RVFs. METHODS: In the present study, we report a case in a 22-year-old female with a chief complaint of obvious passages of flatus or stool through the vagina for 10 years. She had suffered a vaginal trauma from a violent accident 10 years prior, and gradually noticed the uncontrollable passage of gas or feces from the vagina 2 weeks later...
September 2016: Medicine (Baltimore)
S Leardi, B Pessia, M Mascio, F Piccione, M Schietroma, R Pietroletti
INTRODUCTION: The stapled hemorrhoidopexy (SH) and the Doppler-guided transanal hemorrhoidal dearterialization (DG-THD) are minimally invasive procedures for the surgical treatment of hemorrhoids. This study aims to verify the efficacy of the DG-THD versus the SH in the treatment of third-degree hemorrhoids. METHOD: One hundred consecutive patients were causally allocated to either procedure, obtaining two groups of 50 pts. A clinical examination was performed at 3, 7, 15, and 30 days after the operation...
September 6, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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