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https://www.readbyqxmd.com/read/28444558/evolution-of-surgical-treatment-for-rectal-cancer-a-review
#1
Sanjeev Dayal, Nick Battersby, Tom Cecil
Surgery that produces an optimal total mesorectal excision (TME) resection specimen remains the cornerstone of curative rectal cancer management. In the modern era, despite the results of recent randomised trials, laparoscopic TME is a crucial technique in the TME surgery armamentarium. Laparoscopic surgery offers the benefit of magnified views that aid sharp and precise dissection. However operating in the confines of a narrow pelvis, particularly when the mesorectum is bulky, requires significant technical skill...
April 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28436197/magnetic-resonance-imaging-following-neoadjuvant-chemoradiation-and-transanal-endoscopic-microsurgery-for-rectal-cancer
#2
Guilherme P São Julião, Cinthia Denise Ortega, Bruna Borba Vailati, Angelita Habr-Gama, Laura Melina Fernandez, Joaquim Gama-Rodrigues, Sergio Eduardo Araujo, Rodrigo O Perez
AIM: Full thickness local excision after neoadjuvant chemoradiotherapy (CRT) for patients with rectal cancer and incomplete clinical response has been a treatment strategy for organ preservation. Follow up of these patients is challenging since anatomic distortion and postoperative changes may be clinically indistinguishable from tumor recurrence. Magnetic resonance imaging (MRI) may have a role in detecting recurrence. The aim of this study is to describe the MRI findings during follow-up in patients having local excision following CRT with and without local recurrence...
April 24, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28432162/conventional-transanal-excision-for-a-very-low-gastrointestinal-stromal-tumour
#3
Georgios C Sotiropoulos, Paraskevas Stamopoulos, Stylianos Kykalos, Nikolaos Machairas
Gastrointestinal stromal tumour (GIST) represents a rare tumour entity, which has been more intensively investigated during the last decade. The rectum as the primary site of GIST is even uncommon. The space constraints in the pelvis renders optimal oncological surgery demanding and proximity of these lesions to the anal sphincter enhances the potential morbidity of any radical surgery. We herein report on a young patient with a >5 cm rectal GIST localised at 1 cm from the anorectal junction.
April 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28421262/transanal-endoscopic-operation-versus-conventional-transanal-excision-for-rectal-tumors-case-matched-study-with-propensity-score-matching
#4
Jeonghee Han, Gyoung Tae Noh, Chinock Cheong, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
BACKGROUNDS: Although transanal endoscopic surgery is practiced worldwide, there is no consensus on comparative outcomes between transanal endoscopic operation (TEO) and transanal excision (TAE). In this study, we reviewed our experiences with these techniques and compared patients who underwent TEO and TAE using propensity score matching (PSM). METHODS: A total of 207 patients underwent local rectal tumor excision between January 2008 and November 2015. To overcome selection bias, we used PSM to achieve a one-to-one TEO: TAE ratio...
April 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28411888/neoadjuvant-therapy-and-transanal-endoscopic-surgery-in-t2-t3-superficial-n0-m0-rectal-tumors-local-recurrence-complete-clinical-and-pathological-response
#5
Xavier Serra-Aracil, Carlos Pericay, Laura Mora-Lopez, Juan Carlos Garcia Pacheco, José Isaac Latorraca, Julio Ocaña-Rojas, Alex Casalots, Eva Ballesteros, Salvador Navarro-Soto
INTRODUCTION: The association of preoperative chemoradiotherapy and transanal endoscopic surgery in T2 and superficial T3 rectal cancers presents promising results in selected patients. The main objective is to evaluate the long-term loco-regional and systemic recurrence and, as secondary objectives, to provide results of postoperative morbidity and the correlation between complete clinical and pathological response. METHODS: This is a retrospective observational study including a consecutive series of patients with T2-T3 superficial rectal cancer, N0, M0 who refused radical surgery (2008-2016)...
April 12, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28399840/a-multicentre-randomised-controlled-trial-to-evaluate-the-efficacy-morbidity-and-functional-outcome-of-endoscopic-transanal-proctectomy-versus-laparoscopic-proctectomy-for-low-lying-rectal-cancer-etap-greccar-11-trial-rationale-and-design
#6
Bernard Lelong, Cécile de Chaisemartin, Helene Meillat, Sandra Cournier, Jean Marie Boher, Dominique Genre, Mehdi Karoui, Jean Jacques Tuech, Jean Robert Delpero
BACKGROUND: Total mesorectal excision is the standard surgical treatment for mid- and low-rectal cancer. Laparoscopy represents a clear leap forward in the management of rectal cancer patients, offering significant improvements in post-operative measures such as pain, first bowel movement, and hospital length of stay. However, there are still some limits to its applications, especially in difficult cases. Such cases may entail either conversion to an open procedure or positive resection margins...
April 11, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28381943/transanal-total-mesorectal-excision-a-novel-approach-to-rectal-surgery
#7
REVIEW
Pasithorn A Suwanabol, Justin A Maykel
Less invasive approaches continue to be explored and refined for diseases of the colon and rectum. The current gold standard for the surgical treatment of rectal cancer, total mesorectal excision (TME), is a technically precise yet demanding procedure with outcomes measured by both oncologic and functional outcomes (including bowel, urinary, and sexual). To date, the minimally invasive approach to rectal cancer has not yet been perfected, leaving ample opportunity for rectal surgeons to innovate. Transanal TME has recently emerged as a safe and effective technique for both benign and malignant diseases of the rectum...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28381942/transanal-minimally-invasive-surgery
#8
REVIEW
Earl V Thompson, Joshua I S Bleier
Transanal endoscopic surgery (TES) techniques encompass a variety of approaches, including transanal endoscopic microsurgery and transanal minimally invasive surgery. These allow a surgeon to perform local excision of rectal lesions with minimal morbidity and the potential to spare the need for proctectomy. As understanding of the long-term outcomes from these procedures has evolved, so have the indications for TES. In this study, we review the development of TES, its early results, and the evolution of new surgical techniques...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28373976/treatment-and-patient-reported-outcome-in-children-with-hirschsprung-disease-and-concomitant-congenital-heart-disease
#9
Johan Hasserius, Josefine Hedbys, Christina Graneli, Kristine Hagelsteen, Pernilla Stenström
Purpose. Congenital heart disease (CHD) is reported to be associated with Hirschsprung disease (HD). The aim was to evaluate any differences between children with HD with and without CHD, respectively, with regard to patient characteristics, medical care, and patient reported bowel function. Method. This is a retrospective chart study and a cross-sectional long-term follow-up of patients older than 4 years old, including all children with HD operated on with transanal endorectal pull-through (TERPT) at a tertiary center of pediatric surgery...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28355962/indications-and-outcomes-from-32-consecutive-patients-for-the-treatment-of-rectal-lesions-by-transanal-minimally-invasive-surgery
#10
Luis J García-Flórez, Jorge L Otero-Díez, Ana I Encinas-Muñiz, Luis Sánchez-Domínguez
BACKGROUND: The aim of this study was to evaluate the feasibility, safety, perioperative morbidity, and short-term outcomes of the transanal minimally invasive surgery (TAMIS) technique. METHODS: This is a descriptive review of prospectively collected data from 32 consecutive patients who underwent TAMIS procedures in our colorectal unit over a 40-month period. GelPOINT Path port was used in all cases. Demographic data, indications, tumor characteristics, morbidity, and follow-up data were collected...
March 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28304143/anal-function-after-endoluminal-loco-regional-resection-by-transanal-endoscopic-microsurgery-and-radiotherapy-for-rectal-cancer
#11
Ivano Biviano, Andrea Balla, Danilo Badiali, Silvia Quaresima, Giancarlo D'Ambrosio, Emanuele Lezoche, Enrico Corazziari, Alessandro M Paganini
AIM: In patients with rectal cancer, surgery and chemo-radiotherapy may affect the anal sphincter function. Few studies evaluated the ano-rectal function after neoadjuvant chemo-radiotherapy (n-CRT) and/or Transanal Endoscopic Microsurgery (TEM). The aim of this study was to evaluate the effects of n-CRT and TEM on ano-rectal function. METHOD: Thirty-seven patients with rectal cancer underwent ano-rectal manometry and Wexner score for faecal incontinence at baseline, after n-CRT (cT2-T3N0 cancer) and at 4 and 12 months after surgery...
March 17, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28289660/transanal-endoscopic-microsurgery-for-patients-with-rectal-tumors-a-single-institution-s-experience
#12
Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E Samalavicius
PURPOSE: The purpose of this study was to look at our complication rates and recurrence rates, as well as the need for further radical surgery, in treating patients with benign and early malignant rectal tumors by using transanal endoscopic microsurgery (TEM). METHODS: Our study included 130 patients who had undergone TEM for rectal adenomas and early rectal cancer from December 2009 to December 2015 at the Department of Surgical Oncology, National Cancer Institute, Lithuania...
February 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28283986/continuous-transanal-decompression-for-infants-with-long-and-total-type-hirschsprung-s-diseases-as-a-bridge-to-curative-surgery-a-single-center-experience
#13
Kyoko Mochizuki, Masato Shinkai, Norihiko Kitagawa, Hiroshi Take, Hidehito Usui, Takashi Hosokawa, Kaori Yamoto
BACKGROUND: The purpose of this study is to assess the usefulness of continuous bowel decompression using an indwelling transanal tube (ITT) for preoperative management in infants with long-segment (L)- or total (T)-type Hirschsprung's disease (HD). CASE PRESENTATION: Between 2012 and 2015, seven patients with L- or T-type HD underwent preoperative bowel management by continuous bowel decompression using an ITT during waiting period for curative surgery. Continuous bowel decompression was done using an ITT, a 10-12F flexible dual lumen tube placed through the rectum up to the dilated colon under fluoroscopic guidance and secured to the bilateral buttocks...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28280982/risk-factors-for-anastomotic-leakage-after-laparoscopic-surgery-with-the-double-stapling-technique-for-stage-0-i-rectal-carcinoma-a-subgroup-analysis-of-a-multicenter-single-arm-phase-ii-trial
#14
Keitaro Tanaka, Junji Okuda, Seiichiro Yamamoto, Masaaki Ito, Kazuhiro Sakamoto, Yukihito Kokuba, Kenichi Yoshimura, Masahiko Watanabe
PURPOSE: The aim of this study was to determine the risk factors for anastomotic leakage after laparoscopic rectal surgery. METHODS: We conducted a prospective trial involving 395 patients with stage 0/I rectal carcinoma who underwent laparoscopic low anterior resection using a double stapling technique. Data concerning variables related to patient background, tumors and surgical factors were evaluated. The outcomes with respect to anastomotic leakage were recorded, and univariate and multivariate analyses were performed to identify relevant risk factors...
March 9, 2017: Surgery Today
https://www.readbyqxmd.com/read/28273604/mucocele-complicating-stapled-hemorrhoidopexy
#15
Asia Grapsi, Alessandro Sturiale, Bernardina Fabiani, Gabriele Naldini
INTRODUCTION: Stapled hemorrhoidopexy is a safe and effective treatment for circumferential hemorrhoidal prolapse. The overall rate of complications ranges from 12,7% to 36,4% and the surgeon should be aware about their early identification and adequate treatment. PRESENTATION OF CASE: Female patient, 57 years was treated with stapled hemorrhoidopexy. Two years after surgery she reported to our center the occurrence of perineal discomfort, anal spasm and tenesmus...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28265766/combined-transanal-total-mesorectal-excision-tatme-with-laparoscopic-instruments-and-abdominal-robotic-surgery-in-rectal-cancer
#16
R Bravo, J-S Trépanier, M C Arroyave, M Fernández-Hevia, A Pigazzi, A M Lacy
Laparoscopic surgery for rectal cancer can be technically challenging. We describe a hybrid technique combining abdominal robotic dissection and transanal total mesorectal excision. This procedure was performed in a 50-year-old man with rectal adenocarcinoma at 5 cm from the dentate lane. Preoperative staging was T2N0M0. Surgery went well without complications, and estimated blood loss was less than 50 mL. Robotic surgical time was 90 min, and total operative time was 160 min. The patient was discharged on postoperative day 3...
March 6, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28252517/transanal-minimally-invasive-surgery-for-local-excision-of-benign-and-malignant-rectal-neoplasia-outcomes-from-200-consecutive-cases-with-midterm-follow-up
#17
Lawrence Lee, John P Burke, Teresa deBeche-Adams, George Nassif, Beatriz Martin-Perez, John R T Monson, Matthew R Albert, Sam B Atallah
OBJECTIVE: This study describes the outcomes for 200 consecutive transanal minimally invasive surgery (TAMIS) local excision (LE) for rectal neoplasia. BACKGROUND: TAMIS is an advanced transanal platform that can result in high quality LE of rectal neoplasia. METHODS: Consecutive patients from July 1, 2009 to December 31, 2015 from a prospective institutional registry were analyzed. Indication for TAMIS LE was endoscopically unresectable benign lesions or histologically favorable early rectal cancers...
March 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28242026/surgical-approach-for-fecal-incontinence-with-a-patulous-anus-after-transanal-pull-through-for-hirschsprung-disease
#18
Yoshitomo Yasui, Syoichi Nishida, Tsubasa Shironomae, Miwa Satomi, Tsuyoshi Kuwahara, Miyuki Kohno
BACKGROUND: We have performed transanal pull-through (TAPT) for Hirschsprung disease since 1998. Some of our patients after TAPT showed a patulous anus and suffered from severe true fecal incontinence. We performed anal canal plasty for these patients and evaluated its efficacy in restoring anorectal function. METHODS: Thirty-one patients who were ≥5years old were previously operated on for Hirschsprung disease, and seven (22.5%) of these were indicated for this procedure...
February 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28185631/single-stage-transanal-endorectal-pull-through-procedure-for-correction-of-hirschsprung-disease-in-neonates-and-nonneonates-a-multicenter-study
#19
Changgui Lu, Guangjun Hou, Chunyi Liu, Qiming Geng, Xiaoqun Xu, Jie Zhang, Huan Chen, Weibing Tang
PURPOSE: The outcomes of single-stage transanal endorectal pull-through (SSTEPT) for Hirschsprung disease (HSCR) in young patients are favorable; however, reports have shown that diagnosis and surgery at young ages increase the risk for postoperative enterocolitis and slows postoperative recovery. The present study was primarily designed to evaluate the outcomes of SSTEPT in a multi-institutional cohort of neonates and nonneonates with HSCR. METHODS: Between August 2005 and May 2012, a total of 650 children with HSCR were divided into the following two groups: group A (neonatal group, operative age<28days [n=186]); and group B (nonneonatal group, operative age>28days [n=464])...
February 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28177987/quality-of-life-and-functional-outcome-after-transanal-abdominal-transanal-proctectomy-for-low-rectal-cancer
#20
COMPARATIVE STUDY
John H Marks, Jean F Salem, Elsa B Valsdottir, Shadi S Yarandi, Gerald J Marks
BACKGROUND: Transanal abdominal transanal proctectomy is a sphincter-preserving procedure designed to avoid colostomy in patients with cancer in the distal third of the rectum. Oncologic outcomes of this procedure have been established. However, data regarding patient satisfaction and quality of life are scant. OBJECTIVE: The purpose of this study was to evaluate the quality of life and functional outcomes of patients after transanal abdominal transanal proctectomy...
March 2017: Diseases of the Colon and Rectum
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