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Transanal microsurgery

Gerardo Cortese, Gabriele Sales, Giorgia Maiolo, Mario Morino, Martina Scanu, Luca Brazzi
BACKGROUND: The feasibility and safety of transanal endoscopic microsurgery (TEM) performed under spinal anaesthesia (SA) has been recently demonstrated. This retrospective study compared the differences in opioid consumption and postoperative recovery in patients undergoing TEM under GA and SA. METHODS: All consecutive patients who underwent TEM at 'Città della Salute e della Scienza' hospital of Turin (Italy) between January 2012 and December 2015 were enrolled...
March 7, 2018: Minerva Anestesiologica
Stefan H E M Clermonts, Yu-Ting van Loon, Dareczka K Wasowicz, Barbara S Langenhoff, David D E Zimmerman
BACKGROUND: Transanal minimally invasive surgery (TAMIS) is considered the successor of transanal endoscopic microsurgery (TEMS). It makes use of more readily available laparoscopic instruments and single-port access platforms with similar perioperative, clinical and oncological outcomes. Little is known about quality of life (QoL) outcomes after the use of TAMIS. The aim of this study was to assess QoL after TAMIS in our patients and compare this with QoL in the healthy Dutch population...
March 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Matas Jakubauskas, Valdemaras Jotautas, Eligijus Poskus, Saulius Mikalauskas, Gintare Valeikaite-Tauginiene, Kestutis Strupas, Tomas Poskus
PURPOSE: Transanal endoscopic microsurgery (TEM) procedure could potentially influence the development of fecal incontinence later in life. The aim of our study was to assess long-term functional outcomes after TEM and to determine possible variables related to incontinence. METHODS: Patients, enrolled in a prospectively collected TEM operation database, were interviewed using a postal questionnaire. The questionnaire consisted of EuroQol (EQ)-5D-5L quality of life questionnaire, Wexner fecal incontinence grading scale, and additional questions about other perianal operations and obstetric history for women...
February 22, 2018: International Journal of Colorectal Disease
Pilar Hernandez Casanovas, Jesus Bollo Rodriguez, Carmen Martinez Sanchez, Juan Carlos Pernas Canadell, Eduard Maria Targarona Soler
No abstract text is available yet for this article.
February 12, 2018: Cirugía Española
Gang Xu, Peipei Wang, Yao Xiao, Xin Wu, Guole Lin
RATIONALE: Rectal neuroendocrine tumor (NET) is a relatively rare tumor. Well-differentiated NETs (G1 and G2) rarely display distant metastasis at initial diagnosis. Currently, treatment for the primary lesions of rectal NETs with liver metastasis remains controversial. The liver metastasis was resected in local hospital. Transanal endoscopic microsurgery (TEM) has emerged as an effective minimally invasive surgery for local resection of lower rectal lesions. Herein, we reported the initial application of TEM to remove the rectal primary lesion in patients with low rectal NETs (G2) with giant liver metastases...
December 2017: Medicine (Baltimore)
A Crawford, J Firtell, A Caycedo-Marulanda
INTRODUCTION: Locally advanced rectal cancers are most often treated with neoadjuvant chemoradiation followed by surgical resection. However, there are differing opinions surrounding management of rectal cancer, including a lack of consensus on the optimal time interval between chemoradiation and surgery, and the management of patients with complete clinical response following neoadjuvant therapy. This study seeks to summarize management trends for rectal cancer among a sample of Canadian surgeons...
February 1, 2018: Journal of Gastrointestinal Cancer
Zheng-Shui Xu, Hua Cheng, Yuhong Xiao, Jia-Qing Cao, Fei Cheng, Wen-Ji Xu, Jia-Qi Ying, Jun Luo, Wei Xu
Some clinical trials demonstrated local resection for clinical T1 rectal cancer was safe and effective. But for clinical T2 rectal cancer, the results were controversial. Neoadjuvant therapy (NT) is proven to reduce the opportunity of advanced rectal cancer recurrence in various researches. The objective of this Meta-Analysis was to evaluate the oncological outcomes of transanal endoscopic microsurgery (TEM) with or without NT comparing with conventional total mesorectal excision (TME) for the treatment of clinical T2 rectal cancer...
December 29, 2017: Oncotarget
H J S Jones, R Hompes, N Mortensen, C Cunningham
AIM: Minimally-invasive, organ-sparing surgery has been used increasingly for early rectal cancer in recent years. However local recurrence remains a concern. This study presents a ten-year single-centre experience of recurrence after local excision for T1 rectal cancer. METHOD: Data are collected prospectively on all patients undergoing local excision by transanal endoscopic microsurgery (TEM) in a single institution. Data covering a 10-year period were analysed...
January 24, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Dragoş Eugen Georgescu, Mihai Teodor Georgescu, Florin Teodor Bobircă, Teodor Florin Georgescu, Horia Doran, Traian Pătraşcu
Introduction: The current practice for patients with good response, important downstaging or complete remission after preoperative chemoradiation, is to perform surgery on the basis of initial pretherapeutical staging. In literature, varying approaches, like transanal endoscopic microsurgery and even "wait and see", are described for patients with good response after chemoradiation. However, considering the present level of available evidence, the wide-spread adoption of a "watch and wait" policy in those achieving a complete clinical remission cannot be justified...
November 2017: Chirurgia
Anouk J M Rombouts, Issam Al-Najami, Natalie L Abbott, Ane Appelt, Gunnar Baatrup, Simon Bach, Aneel Bhangu, Karen-Lise Garm Spindler, Richard Gray, Kelly Handley, Manjinder Kaur, Ellen Kerkhof, Camilla Jensenius Kronborg, Laura Magill, Corrie A M Marijnen, Iris D Nagtegaal, Lars Nyvang, Femke P Peters, Per Pfeiffer, Cornelis Punt, Philip Quirke, David Sebag-Montefiore, Mark Teo, Nick West, Johannes H W de Wilt
INTRODUCTION: Total mesorectal excision (TME) is the highly effective standard treatment for rectal cancer but is associated with significant morbidity and may be overtreatment for low-risk cancers. This study is designed to determine the feasibility of international recruitment in a study comparing organ-saving approaches versus standard TME surgery. METHODS AND ANALYSIS: STAR-TREC trial is a multicentre international randomised, three-arm parallel, phase II feasibility study in patients with biopsy-proven adenocarcinoma of the rectum...
December 28, 2017: BMJ Open
Xin Wu, Guole Lin, Huizhong Qiu, Jiaolin Zhou
BACKGROUND: Transanal endoscopic microsurgery (TEM) has been accepted worldwide for the treatment of local rectal lesions. Rare rectal tumors consist of several different types of malignant or benign tumors. Surgical management is considered to be the only curative option. The aim of this study is to investigate the role of TEM in the treatment of rare rectal tumors. MATERIALS AND METHODS: A total of 147 patients with rare rectal tumors underwent TEM in our center from April 2006 to May 2017...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
X Serra-Aracil, C Pericay, T Golda, L Mora, E Targarona, S Delgado, A Reina, F Vallribera, J M Enriquez-Navascues, S Serra-Pla, J C Garcia-Pacheco
PURPOSE: The standard treatment of rectal adenocarcinoma is total mesorectal excision (TME), in many cases requires a temporary or permanent stoma. TME is associated with high morbidity and genitourinary alterations. Transanal endoscopic microsurgery (TEM) allows access to tumors up to 20 cm from the anal verge, achieves minimal postoperative morbidity and mortality rates, and does not require an ostomy. The treatment of T2, N0, and M0 cancers remains controversial. Preoperative chemoradiotherapy (CRT) in association with TEM reduces local recurrence and increases survival...
December 12, 2017: International Journal of Colorectal Disease
Narimantas E Samalavičius, Audrius Dulskas, Kęstutis Petrulis, Alfredas Kilius, Renatas Tikuišis, Raimundas Lunevičius
Completion total mesorectal excision (TME) is a rare but complex procedure after transanal endoscopic microsurgery for early rectal cancer with unfavourable final histology. Two cases are reported when completion TME was performed after upfront transanal partial mesorectal dissection. Intact non-perforated TME specimens with negative and adequate distal and circumferential margins were created. The quality of both total mesorectal excisions was complete and distal margins were sufficient. We believe that our technique might be a way of approaching completion TME after TEM, especially in cases of low rectal cancer...
2017: Acta Medica Lituanica
Ian Bloomfield, Roelof Van Dalen, Simione Lolohea, Linus Wu
BACKGROUND: Transanal endoscopic microsurgery (TEMS) is a proven alternative therapy to either radical surgery or endoscopic mucosal resection for rectal neoplasms. It has proven benefits with lower morbidity and mortality compared with total mesorectal excision, and a lower local recurrence rate when compared to endoscopic mucosal techniques. METHODS: A retrospective data collection of TEMS procedures performed through Waikato District Health Board, New Zealand, from 2010 to 2015 was conducted...
December 3, 2017: ANZ Journal of Surgery
Guilherme Pagin São Julião, Juan Pablo Celentano, Flavia Andrea Alexandre, Bruna Borba Vailati
Radical surgery is considered as the standard treatment for rectal cancer. Transanal local excision has been considered an interesting alternative for the management of selected patients with rectal cancers for many decades. Different approaches had been considered for local excision, from endoscopic submucosal dissection to resections using platforms, such as transanal endoscopic microsurgery or transanal minimally invasive surgery. Identifying the ideal candidate for this approach is crucial, as a local failure after local excision is associated with poor outcomes, even for an initial early rectal tumor...
November 2017: Clinics in Colon and Rectal Surgery
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
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
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...
January 2018: European Journal of Gastroenterology & Hepatology
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
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
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