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Transanal microsurgery

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
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
Monica Ortenzi, Roberto Ghiselli, Maria Michela Cappelletti Trombettoni, Luca Cardinali, Mario Guerrieri
AIM: To analyze the outcomes of transanal endoscopic microsurgery (TEM) in the treatment of rare rectal condition like mesenchymal tumors, condylomas, endometriosis and melanoma. METHODS: We retrospectively reviewed a twenty-three years database. Fifty-two patients were enrolled in this study. The lesions were considered suitable for TEM if they were within 20 cm from the anus. All of them underwent an accurate preoperative workup consisting in clinical examination, total colonoscopy with biopsies, endoscopic ultrasonography, and pelvic computerized tomography or pelvic magnetic resonance imaging...
September 16, 2016: World Journal of Gastrointestinal Endoscopy
Issam Al-Najami, Carl Philip Rancinger, Morten Kobaek Larsen, Niels Thomassen, Niels Buch, Gunnar Baatrup
Transanal endoscopic microsurgery (TEM) allows for the resection of large adenomas and early stage cancers in the rectum. The rate of complications and recurrence for malignant tumors compared with benign tumors has been questioned.The objective of our study was to analyze the outcome after TEM procedures for adenomas and cancers with focus on local recurrence and complications.All 280 patients who had a TEM procedure between January 2008 and September 2015 were enrolled in a prospective cohort study. Outcome was described for benign and malignant tumors...
September 2016: Medicine (Baltimore)
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)
Katherine A Kelley, V Liana Tsikitis
Appropriate endoscopic resection for colorectal polyps can present a challenge to endoscopists, as these lesions may harbor malignancy. With recent advances in endoscopy, however, we are now entering an exciting frontier of endoscopic therapy for gastrointestinal lesions. These techniques include endoluminal mucosal resection and endoscopic submucosal dissection, which may be utilized on several colonic lesions. This article will discuss these principle endoscopic techniques, their outcomes, and briefly highlight their influence on endoscopic interventions, including transanal endoscopic microsurgery and natural orifice transluminal endoscopic surgery...
September 2016: Clinics in Colon and Rectal Surgery
R Zhou, B A Orkin
Iatrogenic colonic perforations are relatively uncommon but serious complications of diagnostic and therapeutic colonoscopies. Transanal endoscopic microsurgery (TEM) is an useful approach to the rectum and may be used for repair of a rectal perforation during colonoscopy. A 56-year-old male had an iatrogenic perforation of the rectum during a routine follow-up colonoscopy repaired by TEM with an uneventful and rapid recovery.
October 2016: Techniques in Coloproctology
G Gallo, G Clerico, A R Luc, M Trompetto
No abstract text is available yet for this article.
August 23, 2016: Techniques in Coloproctology
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
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
Balazs Banky, Mahsa Saleki, Talvinder S Gill
A 29-year-old woman with known history of endometriosis was referred to colorectal outpatient clinic from gynaecology with a history of intermittent rectal bleeding and no associated bowel symptoms. Flexible sigmoidoscopy in concordance with pelvic MRI revealed a 3×2×2 cm sessile lesion in the anterior rectal wall. The lesion was also palpable as a firm mass on digital rectal examination. From the gynaecological point of view no intra-abdominal exploration was required; the sole rectal wall lesion was removed with the minimally invasive surgical technique of transanal endoscopic microsurgery...
2016: BMJ Case Reports
Thibaud Koessler, Philippe Bichard, Vincent Lepilliez, Giacomo Puppa, Frederic Ris, Arnaud Roth
Colorectal polyps are frequent in the general population. The diagnostic is made by endoscopy. Polyp's characteristics determine the technic to be used to remove them. Transanal endoscopic microsurgery offers an alternative to radical surgery for large rectal polyps or rectal tumors with low risk of node invasion. One peace resection is necessary to evaluate the resection margins. Lymphatic invasion, ≥ 1 mm submucosae invasion, tumor budding and poorly differentiated tumor are the four main risk factors for node invasion...
May 18, 2016: Revue Médicale Suisse
Carl Brown, Manoj J Raval, P Terry Phang, Ahmer A Karimuddin
BACKGROUND: To determine whether closure of the defect created during full thickness excision of a rectal lesion with transanal endoscopic microsurgery (TEM) leads to fewer complications when compared to leaving the defect unsutured. METHODS: This is a single-center cohort study using a prospectively maintained database. All patients ≥18 years old treated with full thickness TEM with no compromise of the peritoneal cavity were included. Two cohorts were established: patients with the defect sutured and patients with the defect left open...
July 7, 2016: Surgical Endoscopy
Jean-Sébastien Trépanier, María Fernandez-Hevia, Antonio M Lacy
Minimally invasive techniques (MIS) have been evolving quickly in colorectal surgery during the last two decades. Transanal total mesorectal excision (taTME) was developed as a combination of skills acquired from different MIS approaches such as Transanal Endoscopic Microsurgery (TEM), Transanal Minimally Invasive Surgery (TAMIS) and Natural Orifices Transluminal Endoscopic Surgery (NOTES). TaTME allows for a better visualization of surgical planes of dissection and achievement of rectal resection following oncologic principles...
October 2016: Minimally Invasive Therapy & Allied Technologies: MITAT
Shingo Noura, Masayuki Ohue, Norikatsu Miyoshi, Masayoshi Yasui
Transanal endoscopic microsurgery (TEM) is a minimally invasive technique. However, TEM has not yet achieved widespread use. Recently, transanal minimally invasive surgery (TAMIS) using single-port surgery devices has been reported. In the present study, TAMIS using a GelPOINT(®) Path was performed in six patients with lower rectal cancer. A complete full-thickness excision was performed in all cases. The patient characteristics, operative techniques and operative outcomes were evaluated. The mean age of the patients was 63...
July 2016: Molecular and Clinical Oncology
Tore Stornes, Arne Wibe, Arild Nesbakken, Tor Å Myklebust, Birger H Endreseth
BACKGROUND: Treatment of early stage rectal cancer has excellent oncological results. To reduce treatment-related mortality and morbidity and improve functional results, a focus on local resections is increasingly important. OBJECTIVE: The purpose of this study was to compare outcomes after transanal endoscopic microsurgery and total mesorectal excision for early stage rectal cancer (T1 + T2) in Norway. DESIGN: This was an observational study based on prospective data from the Norwegian Colorectal Cancer Registry...
July 2016: Diseases of the Colon and Rectum
Hayim Gilshtein, Simon-Daniel Duek, Wisam Khoury
Transanal endoscopic microsurgery is part of the colorectal surgeons' armamentarium for over 2 decades. Since its first implementation for the resection of benign and T1 malignant lesions in the rectum several new indications were developed and it carries additional promise for further extension in upcoming years. Herein we review the technique, its current indications, novel implications, and future perspectives.
June 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
C J Smart, S Korsgen, J Hill, D Speake, B Levy, M Steward, J I Geh, J Robinson, D Sebag-Montefiore, S P Bach
BACKGROUND: Organ-preserving treatment for early-stage rectal cancer may avoid the substantial perioperative morbidity and functional sequelae associated with total mesorectal excision (TME). The initial results of an organ-preserving approach using preoperative short-course radiotherapy (SCRT) and transanal endoscopic microsurgery (TEMS) are presented. METHODS: Patients with cT1-2N0 rectal cancers staged using high-quality MRI and endorectal ultrasonography received SCRT, with TEMS 8-10 weeks later, at four regional referral centres between 2007 and 2013...
July 2016: British Journal of Surgery
Naoki Ishii, Hitoshi Akiyama, Koyu Suzuki, Yoshiyuki Fujita
A 47-year-old woman underwent prophylactic subtotal colectomy with ileorectal anastomosis (IRA) for familial adenomatous polyposis (FAP) 18 years ago. She underwent 5 transanal endoscopic microsurgeries for rectal remnant polyps, and was referred for the treatment of rectal remnant polyp recurrence. Endoscopic submucosal dissection (ESD) was performed to remove multiple polypoid lesions that circumferentially extended throughout the rectal remnant with lesions spreading onto the anastomotic site. The rectal remnant mucosa was resected in 2 pieces without complication...
April 2016: ACG Case Reports Journal
Calogero Cipolla, Giuseppina Ferro, Giuseppa Graceffa, Lorenzo Morini, Giuseppina Guercio, Salvatore Vieni, Gianni Pantuso
UNLABELLED: represents a safe and complete technique to remove benign lesions of the rectum not treatable by endoscopy and malignant rectal lesions at early stage. It is a valid alternative to transanal endoscopic microsurgery (TEM), to conventional transanal surgery and to transabdominal resection. METHODS: In our operating Unit we performed a resection of 8 voluminous adenoma in the rectal ampulla with SILSTM-Port. RESULTS: The mean age of the patients was of 51...
2016: Annali Italiani di Chirurgia
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