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Transanal surgery

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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
#1
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/29130230/-protective-measures-in-laparoscopic-resection-for-upper-or-mid-rectal-cancer-and-sigmoid-colon-cancer-with-transrectal-specimen-extraction-surgery
#2
Chuangang Fu, Zhuqing Zhou, Junyi Han, Bin Lu, Wei Gao, Zhe Zhu, Qixin Jiang, Fang Ji, Tao Du
OBJECTIVE: To introduce the use of a self-made specimen protective sleeve in laparoscopic resection for upper or mid rectal cancer and sigmoid colon cancer with transrectal specimen extraction surgery and the improvement of implantation method, so as to avoid and reduce bacterial contamination and tumor cell dissemination in abdominal cavity. METHODS: During June 2015 and May 2017, 48 cases of high located rectal or sigmoid colon cancer were operated laparoscopically with natural orifices specimen extraction surgery (NOSES) using a self-made specimen protecting sleeve...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29127965/minimally-invasive-neonatal-surgery-hirschsprung-disease
#3
REVIEW
Atsuyuki Yamataka, Go Miyano, Masahiro Takeda
Transanal pull-through (TAPT) is the procedure of choice for treating Hirschsprung disease and should be performed with laparoscopic assistance using the anorectal line (ARL) to ensure optimum postoperative bowel function (POBF). The dentate line (DL) has traditionally been used as the landmark for commencing dissection during TAPT, but we prefer the ARL because the DL is too subjective and can be associated with risk for injury to delicate sensory innervation required for normal defecation in the anal transition zone...
December 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/29098433/effect-of-transanal-total-mesorectal-excision-for-rectal-cancer-comparison-of-short-term-outcomes-with-laparoscopic-and-open-surgeries
#4
Sharaf Karim Perdawood, Benjamin Sejr Thinggaard, Maya Xania Bjoern
OBJECTIVE: To compare short-term results of total mesorectal excision (TME) for mid and low rectal cancer, achieved by transanal (TaTME), laparoscopic (LaTME), and open (OpTME) approaches. BACKGROUND: The impact of TaTME on the surgical treatment of mid and low rectal cancer has yet to be clarified. METHODS: This is a case-matched study, based on data from a prospectively maintained database of patients who underwent TaTME from May 2015 to March 2017, and a retrospective chart review of patients who underwent LaTME and OpTME in the previous period...
November 2, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29074726/outcomes-following-polypectomy-for-malignant-colorectal-polyps-are-similar-to-those-following-surgery-in-the-general-population
#5
Anthony Lopez, Anne-Marie Bouvier, Valérie Jooste, Vanessa Cottet, Gaëlle Romain, Jean Faivre, Sylvain Manfredi, Come Lepage
OBJECTIVE: Population-based studies on colorectal malignant polyps (MPs) are scarce. The aim of this study was to describe time trends in the incidence of colorectal MPs before and after the introduction of a colorectal mass-screening programmein 2003 and to assess outcomes (survival and recurrence) after endoscopic or surgical resection in patients with MPs. DESIGN: We included 411 patients with MPs diagnosed between 1982 and 2011 in a well-defined population. Age-standardised incidence rates were calculated...
October 26, 2017: Gut
https://www.readbyqxmd.com/read/29067939/a-case-of-total-laparoscopic-sigmoidectomy-involving-the-use-of-needle-forceps-and-transanal-specimen-extraction-for-sigmoid-colon-cancer
#6
Rina Takahashi, Kazuhiro Sakamoto, Hisashi Ro, Kazumasa Kure, Masaya Kawai, Shun Ishiyama, Kiichi Sugimoto, Yutaka Kojima, Atsushi Okuzawa, Yuichi Tomiki
A 76-year-old male underwent endoscopic mucosal resection for a stage T1 tumour of the sigmoid colon. We performed laparoscopic sigmoidectomy through 5 ports using needlescopic instruments. The resected specimen was extracted from the abdominal cavity transanally. After attaching an anvil to the sigmoidal stump, the rectal stump was reclosed using an endoscopic linear stapler, and then, colorectal anastomosis was conducted using the double stapling technique. Performing transanal specimen extraction using needlescopic forceps improves aesthetic outcomes and reduces post-operative pain and the risk of abdominal incisional hernias...
October 23, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29064849/the-outcome-of-transanal-endoscopic-microsurgery-in-obese-patients
#7
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/29063219/treatment-of-obstructed-defecation-syndrome-due-to-rectocele-and-rectal-intussusception-with-a-high-volume-stapler-tst-starr-plus
#8
G Naldini, B Fabiani, C Menconi, I Giani, G Toniolo, D Mascagni, J Martellucci
BACKGROUND: In recent years, stapled transanal resection (STARR) has been adopted worldwide with convincing short-term results. However, due to the high recurrence rate and some major complications after STARR, there is still controversy about when the procedure is indicated. The aim of this study was to assess the safety, efficacy and feasibility of STARR performed with a new dedicated device for tailored transanal stapled surgery. METHODS: All the consecutive patients affected by obstructed defecation syndrome (ODS) due to rectocele or/and rectal intussusception, who underwent STARR with the TST STARR-Plus stapler, were included in a prospective study...
October 23, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29062451/two-cases-of-laparoscopic-total-colectomy-with-natural-orifice-specimen-extraction-and-review-of-the-literature
#9
Ersin Gundogan, Aydin Aktas, Cuneyt Kayaalp, Fatih Gonultas, Fatih Sumer
We present two cases of natural orifice specimen extraction (NOSE) after laparoscopic total colectomy and ileorectal anastomosis (TC-IRA), and we also review all of the previously reported cases. Our aim was to focus on patient selection for NOSE after TC-IRA. The PubMed and Google Scholar databases were scanned. Demographic features, surgical indications, and techniques were analyzed. Basic calculations were used for statistical analysis. A total of 13 cases were detected in addition to our 2 cases. All of the specimens were removed through the natural orifices successfully...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
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/29050194/update-on-the-pathophysiology-and-management-of-anorectal-disorders
#11
REVIEW
Tanisa Patcharatrakul, Satish S C Rao
Anorectal disorders are common and present with overlapping symptoms. They include several disorders with both structural and functional dysfunction(s). Because symptoms alone are poor predictors of the underlying pathophysiology, a diagnosis should only be made after evaluating symptoms and physiologic and structural abnormalities. A detailed history, a thorough physical and digital rectal examination and a systematic evaluation with high resolution and/or high definition three-dimensional (3D) anorectal manometry, 3D anal ultrasonography, magnetic resonance defecography and neurophysiology tests are essential to correctly identify these conditions...
October 23, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28993914/operative-vectors-anatomic-distortion-fluid-dynamics-and-the-inherent-effects-of-pneumatic-insufflation-encountered-during-transanal-total-mesorectal-excision
#12
S Atallah, P Gonzalez, S Chadi, R Hompes, J Knol
BACKGROUND: Transanal total mesorectal excision (taTME) is an altogether different approach to rectal cancer surgery, and the effects of carbon dioxide (CO2) on this dissection remain poorly described. METHODS: This article critically examines the effect of carbon dioxide insufflation and the workspace it creates during the process of taTME. The unique aspects of insulation with this approach are governed by the laws of physics, especially the principles of fluid dynamics, an area that remains poorly described for laparoscopy and not at all described for taTME...
October 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28991089/retained-needle-following-transanal-hemorrhoidal-dearterialization
#13
Valerio Celentano, Anjan Banerjee, Federico Luvisetto, Syed Naqvi, Jim Khan
INTRODUCTION: A needle was retained during transanal hemorrhoidal dearterialization. This rare complication has not been described before. TECHNIQUE: A spinal needle was inserted from the perianal skin to localize the retained foreign body that was located at 7 cm from the anal margin. A decision was made to proceed to intersphincteric dissection, and a 3-cm incision was made in the perianal skin from 2 to 4 o'clock. Deep pararectal dissection continued, and the needle was eventually found lying in the muscular layer, parallel to the plane of the dissection...
November 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28985874/bioscaffold-mediated-mucosal-remodeling-following-short-segment-colonic-mucosal-resection
#14
Jenna L Dziki, Timothy J Keane, Shahab Shaffiey, Dan Cognetti, Neill Turner, Deborah Nagle, David Hackam, Stephen Badylak
Precancerous or cancerous lesions of the gastrointestinal tract often require surgical resection via endomucosal resection. Although excision of the colonic mucosa is an effective cancer treatment, removal of large lesions is associated with high morbidity and complications including bleeding, perforation, fistula formation, and/or stricture, contributing to high clinical and economic costs and negatively impacting patient quality of life. The present study investigates the use of a biologic scaffold derived from extracellular matrix (ECM) to promote restoration of the colonic mucosa following short segment mucosal resection...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28983691/hirschsprung-s-disease-in-the-laparoscopic-transanal-pull-through-era-implications-of-age-at-surgery-and-technical-aspects
#15
Go Miyano, Masahiro Takeda, Hiroyuki Koga, Manabu Okawada, Nana Nakazawa-Tanaka, Junya Ishii, Takashi Doi, Geoffrey J Lane, Tadaharu Okazaki, Masahiko Urao, Atsuyuki Yamataka
AIM: Detailed implications of age at laparoscopic transanal pull-through (LTAPT) on postoperative bowel function (POBF) in Hirschsprung's disease (HD) are somewhat obscure because of a spectrum of factors. METHODS: Age at surgery was used to categorize 106 consecutive postoperative HD cases treated by our modified LTAPT (JLTPAT) between 1997 and 2015; group A: < 3 months old (n = 31); group B: 3-11 months old (n = 44); group C: 1-3 years old (n = 19); and group D: ≥ 4 years old (n = 12)...
October 5, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28963594/transanal-endoscopic-microsurgery-for-giant-benign-rectal-tumours-is-large-size-a-contraindication
#16
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...
September 30, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28931290/-obstructed-defecation-syndrome-review-article
#17
L Sákra, J Šiller
INTRODUCTION: Obstructed defecation syndrome (ODS) is one of the main causes of primary constipation. It is caused by anatomical disorders in the pelvic floor region (rectocoele, en-terocoele, rectal intussusception, rectal prolapse), but it always occurs in combination with a functional defect of defecation. This review provides a comprehensive view of the diagnosis and treatment of the syndrome. METHOD: Treatment may be conservative or surgical. Conservative treatment involves a complex of approaches to the practice of defecation, regime and dietary measures together with pelvic floor rehabilitation and psychological support...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28916253/the-place-of-transanal-endoscopic-surgery-in-the-treatment-of-rectourethral-fistula
#18
Xavier Serra-Aracil, Meritxell Labró-Ciurans, Laura Mora-López, Jesús Muñoz-Rodríguez, Raúl Martos-Calvo, Joan Prats-López, Salvador Navarro-Soto
OBJECTIVE: To assess the role of transanal endoscopic operation (TEO) or transanal endoscopic microsurgery (TEM) in rectourethral fistulas (RUF). RUF may appear after radical prostatectomy. Their treatment represents a challenge; many therapies have been proposed, from conservative to aggressive surgical approaches. Transanal endoscopic surgery (TEO or TEM) is a minimally invasive technique to access the site of the RUF to perform repair. MATERIALS AND METHODS: This is an observational study with prospective data collection, conducted between September 2006 and December 2015...
September 12, 2017: Urology
https://www.readbyqxmd.com/read/28905101/transanal-minimally-invasive-surgery-for-rectal-polyps-and-selected-malignant-tumors-caution-concerning-intermediate-term-functional-results
#19
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...
September 13, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28900991/-transanal-endoscopic-microsurgery-for-treatment-of-rectal-neuroendocrine-tumors
#20
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
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