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Transanal microsurgery

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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/29111832/the-use-of-antibiotics-before-transanal-endoscopic-microsurgery
#2
Andrea Balla
No abstract text is available yet for this article.
November 7, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29064849/the-outcome-of-transanal-endoscopic-microsurgery-in-obese-patients
#3
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/29064311/transanal-endoscopic-microsurgery-implementation-in-ultra-low-anterior-resection
#4
Hayim Gilshtein, Mariya Neymark, Elias Manassa, Wisam Khoury, Daniel Duek
BACKGROUND: Distal rectal cancer resection is an ongoing challenge for the colorectal surgeon. In recent years new technical approaches, especially with implementation of transanal platforms were developed to help in the visualization and resection of these tumors. Nevertheless, the use of these platforms is demanding with significant complications during the onset phase. METHODS: Patients with very low rectal cancer were operated on in a single tertiary center with a combined abdominal and transanal endoscopic microsurgery (TEM) approach...
October 24, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29052070/the-feasibility-of-laparoscopic-rectal-resection-in-patients-undergoing-reoperation-after-transanal-endoscopic-microsurgery-tem
#5
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/29030001/the-occurrence-and-characteristics-of-endoscopically-unexpected-malignant-degeneration-in-large-rectal-adenomas
#6
Maxime E S Bronzwaer, Gijsbert D Musters, Renée M Barendse, Lianne Koens, Eelco J R de Graaf, Pascal G Doornebosch, Mathijs P Schwartz, Esther C J Consten, Erik J Schoon, Ignace H J T de Hingh, Pieter J Tanis, Evelien Dekker, Paul Fockens
INTRODUCTION: Large non-pedunculated rectal polyps are most commonly resected by endoscopic mucosal resection (EMR) or transanal endoscopic microsurgery (TEM). Despite preprocedural diagnostics, unexpected rectal cancer is incidentally encountered within the resected specimen. This study aimed to compare the diagnostic assessment and procedural characteristics of lesions with and without unexpected submucosal invasion. METHODS: A post-hoc analysis of a multicenter randomized trial (TREND study) was performed, in which patients with a non-pedunculated rectal polyp of ≥3 cm without endoscopic suspicion of invasive growth were randomized between EMR and TEM...
October 10, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28963594/transanal-endoscopic-microsurgery-for-giant-benign-rectal-tumours-is-large-size-a-contraindication
#7
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/28905101/transanal-minimally-invasive-surgery-for-rectal-polyps-and-selected-malignant-tumors-caution-concerning-intermediate-term-functional-results
#8
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
#9
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
https://www.readbyqxmd.com/read/28871476/peritoneal-perforation-is-less-a-complication-than-an-expected-event-during-transanal-endoscopic-microsurgery-experience-from-194-consecutive-cases
#10
D Mege, N Petrucciani, L Maggiori, Y Panis
BACKGROUND: Indications for transanal endoscopic microsurgery (TEM) have been extended to technically challenging tumors, which may be associated with an increased risk of peritoneal perforation (PP). The aim of the present study was to investigate the occurrence, management and outcome of PP in patients having TEM. METHODS: All the patients who had TEM for rectal adenoma or adenocarcinoma in our unit were included. Patients in whom PP occurred (Group A) were compared to those without PP (Group B)...
September 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28836241/-standardized-development-of-transanal-endoscopic-microsurgery
#11
Guole Lin
Transanal endoscopic microsurgery (TEM) is currently the only one-port system in endoscopic surgery, which a direct endoluminal approach can lead to the target organ through a natural opening of human body. TEM has been applied in colorectal surgery for over 3 decades. Compared with radical surgery, TEM has the advantages, such as quicker recovery, shorter hospital stay and fewer complications. One perfect TEM surgical system, which mainly consists of three parts, namely peculiar rectoscope for surgery, special surgical instruments and imaging system, is the foundation of standardized development of TEM...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28829669/clinical-values-of-preoperative-use-of-antibiotics-in-transanal-endoscopic-microsurgery
#12
Jingbo Chen, Yupeng Li, Xiangpeng Xi, Lili Qiao, Mingyu Yang, Lijian Xia, Yanbing Zhou
OBJECTIVE: To investigate the clinical values of preoperative use of antibiotics in transanal endoscopic microsurgery (TEM). METHODS: Thirty patients undergoing TEM surgery to treat rectal neoplasms in our hospital were selected in this study. All patients were randomly divided into two groups: antibiotic group that antibiotics were used before and after surgery, and control group that antibiotics were only used after surgery. Several markers were evaluated before and after surgery in all patients, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), changes procalcitonin (PCT), white blood cell count (WBC), neutrophils (NE%) and temperature (T)...
August 22, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28812153/establishing-the-learning-curve-of-transanal-minimally-invasive-surgery-for-local-excision-of-rectal-neoplasms
#13
Lawrence Lee, Justin Kelly, George J Nassif, Deborah Keller, Teresa C Debeche-Adams, Paul A Mancuso, John R Monson, Matthew R Albert, Sam B Atallah
INTRODUCTION: Transanal minimally invasive surgery (TAMIS) is an endoscopic operating platform for local excision of rectal neoplasms. However, it may be technically demanding, and its learning curve has yet to be adequately defined. The objective of this study was to determine the number of TAMIS procedures for the local excision of rectal neoplasm required to reach proficiency. METHODS AND PROCEDURES: All TAMIS cases performed from 07/2009 to 12/2016 at a single high-volume tertiary care institution for local excision of benign and malignant rectal neoplasia were identified from a prospective database...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28796731/quality-of-local-excision-for-rectal-neoplasms-using-transanal-endoscopic-microsurgery-versus-transanal-minimally-invasive-surgery-a-multi-institutional-matched-analysis
#14
MULTICENTER STUDY
Lawrence Lee, Kimberly Edwards, Iain A Hunter, John E Hartley, Sam B Atallah, Matthew R Albert, James Hill, John R Monson
BACKGROUND: There are no data comparing the quality of local excision of rectal neoplasms using transanal endoscopic microsurgery and transanal minimally invasive surgery. OBJECTIVE: The purpose of this study was to compare the incidence of tumor fragmentation and positive margins for patients undergoing local excision of benign and malignant rectal neoplasms using transanal endoscopic microsurgery versus transanal minimally invasive surgery. DESIGN: This was a multi-institutional cohort study using coarsened exact matching...
September 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28761873/pneumoretroperitoneum-and-sepsis-after-transanal-endoscopic-resection-of-a-rectal-lateral-spreading-tumor
#15
Bruno Augusto Alves Martins, Marcelo de Melo Andrade Coura, Romulo Medeiros de Almeida, Natascha Mourão Moreira, João Batista de Sousa, Paulo Gonçalves de Oliveira
Transanal endoscopic microsurgery is considered a safe, appropriate, and minimally invasive approach, and complications after endoscopic microsurgery are rare. We report a case of sepsis and pneumoretroperitoneum after resection of a rectal lateral spreading tumor. The patient presented with rectal mucous discharge. Colonoscopy revealed a rectal lateral spreading tumor. The patient underwent an endoscopic transanal resection of the lesion. He presented with sepsis of the abdominal focus, and imaging tests revealed pneumoretroperitoneum...
June 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28723770/initial-application-of-transanal-endoscopic-microsurgery-for-high-risk-lower-rectal-gastrointestinal-stromal-tumor-after-imatinib-mesylate-neoadjuvant-chemotherapy-a-case-report
#16
Qiaofei Liu, Guangxi Zhong, Weixun Zhou, Guole Lin
RATIONALE: The lower rectal gastrointestinal stromal tumor (GIST) is a rare entity and warrants special attentions because of the considerations of preserving of anal and urinal functions. Neoadjuvant therapy with imatinib mesylate (IM) has achieved great success in GIST, which potentially extends the applications of function-preserving minimally invasive surgical procedures. Transanal endoscopic microsurgery (TEM) is a well-developed minimally invasive technique for benign tumors in lower rectum...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28667480/mri-surveillance-for-the-detection-of-local-recurrence-in-rectal-cancer-after-transanal-endoscopic-microsurgery
#17
Britt J P Hupkens, Monique Maas, Milou H Martens, Willem M L L G Deserno, Jeroen W A Leijtens, Patty J Nelemans, Frans C H Bakers, Doenja M J Lambregts, Geerard L Beets, Regina G H Beets-Tan
OBJECTIVES: To evaluate diagnostic performance of follow-up MRI for detection of local recurrence of rectal cancer after transanal endoscopic microsurgery (TEM). METHODS: Between January 2006 and February 2014, 81 patients who underwent TEM were included. Two expert readers (R1 and R2), independently evaluated T2-weighted (T2W) MRI and diffusion-weighted (DWI) MRI for the detection of local recurrence, retrospectively, and recorded confidence on a five-point scale...
December 2017: European Radiology
https://www.readbyqxmd.com/read/28659349/randomised-controlled-trial-of-transanal-endoscopic-microsurgery-versus-endoscopic-mucosal-resection-for-large-rectal-adenomas-trend-study
#18
Renée M Barendse, Gijsbert D Musters, Eelco J R de Graaf, Frank J C van den Broek, Esther C J Consten, Pascal G Doornebosch, James C Hardwick, Ignace H J T de Hingh, Chrisiaan Hoff, Jeroen M Jansen, A W Marc van Milligen de Wit, George P van der Schelling, Erik J Schoon, Matthijs P Schwartz, Bas L A M Weusten, Marcel G Dijkgraaf, Paul Fockens, Willem A Bemelman, Evelien Dekker
OBJECTIVE: Non-randomised studies suggest that endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM), but EMR might be more cost-effective and safer. This trial compares the clinical outcome and cost-effectiveness of TEM and EMR for large rectal adenomas. DESIGN: Patients with rectal adenomas ≥3 cm, without malignant features, were randomised (1:1) to EMR or TEM, allowing endoscopic removal of residual adenoma at 3 months...
June 28, 2017: Gut
https://www.readbyqxmd.com/read/28657837/mckittrick-wheelock-syndrome-treated-by-transanal-minimally-invasive-surgery-a-single-center-experience-and-review-of-the-literature
#19
Anne Elisabeth Maria van der Pool, Eelco Jan Rade de Graaf, Maarten Vermaas, Renée Martine Barendse, Pascal Gabriël Doornebosch
INTRODUCTION: McKittrick Wheelock Syndrome (MKWS) is a rare syndrome characterized by secretory diarrhea, dehydration, prerenal acute kidney injury, and severe electrolyte abnormalities caused by a large hypersecretory villous adenoma located in the rectum or rectosigmoid junction. Transabdominal (laparoscopic) procedures are the most described procedures in the treatment of MKWS. We report an alternative surgical approach, transanal minimally invasive surgery (TAMIS), to solve this syndrome...
June 28, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28656075/value-of-macrobiopsies-and-transanal-endoscopic-microsurgery-in-the-histological-work-up-of-rectal-neoplasms-a-retrospective-study
#20
Guus M J Bökkerink, Gert-Jan van der Wilt, Dirk de Jong, Han H J M van Krieken, Robert P Bleichrodt, Johannes H W de Wilt, Andreas J A Bremers
AIM: To evaluate a step up approach: Taking macrobiopsies and performing excision biopsies in patients with suspected rectal cancer in which biopsies taken though the flexible endoscope showed benign histology. METHODS: Patients with a rectal neoplasm who underwent flexible endoscopy and biopsies were included. In case of benign biopsies rigid rectoscopy and macrobiopsies were employed. If this failed to prove malignancy, transanal endoscopic microsurgery (TEM) was used in a final effort to establish a certain preoperative diagnosis...
June 15, 2017: World Journal of Gastrointestinal Oncology
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