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Transanal excision

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https://www.readbyqxmd.com/read/28436197/magnetic-resonance-imaging-following-neoadjuvant-chemoradiation-and-transanal-endoscopic-microsurgery-for-rectal-cancer
#1
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
#2
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
#3
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/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
#4
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
#5
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
#6
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/28358587/a-novel-curative-treatment-strategy-for-patients-with-lower-grade-rectal-gastrointestinal-stromal-tumor-chemoreduction-combined-with-transanal-endoscopic-microsurgery
#7
Xianlin Han, Jing Xu, Huizhong Qiu, Guole Lin
BACKGROUND: A multimodal treatment has been applied for patients with rectal gastrointestinal stromal tumor (GIST) that represents 5% of the total localization. Meanwhile, transanal endoscopic microsurgery (TEM) offers a minimally invasive method for full-thickness tumor excision with negative margins and low morbidity. We report the single most extensive analysis of data from China to evaluate the feasibility and safety of the procedure combined with neoadjuvant imatinib therapy to treat patients with rectal GISTs...
March 30, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28355962/indications-and-outcomes-from-32-consecutive-patients-for-the-treatment-of-rectal-lesions-by-transanal-minimally-invasive-surgery
#8
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/28350289/rectal-carcinoid-tumor-with-liver-metastases-treated-by-local-excision-and-orthotopic-liver-transplant-with-long-term-follow-up
#9
Giovanni Vennarecci, Gianluca Mascianà, Edoardo de Werra, Nicola Guglielmo, Giovanni Battista Levi Sandri, Mariagrazia Coluzzi, Giuseppe Maria Ettorre
In patients affected by unresectable liver metastases from neuroendocrine tumor, liver transplant represents currently the only realistic chance for cure. The first attempt to establish selection criteria for liver transplant in patients affected by neuroendocrine tumor liver metastases was made by Mazzaferro and associates in 2007. We report the case of a 46-year-old man who came to our institution in 2006 with right upper quadrant abdominal pain. Diagnosis of rectal neuroendocrine tumor with bilobar liver nodules was made; the patient underwent transanal local resection...
March 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28346223/early-rectal-cancer-a-choice-between-local-excision-and-transabdominal-resection-a-review-of-the-literature-and-current-guidelines
#10
Giuseppe Pappalardo, Massimo Chiaretti
INTRODUCTION: Indication for Local Excision (LE) or Trans Abdominal Resections with Total Mesorectal Excision (TAR) in Early Rectal Cancer (ERC) are still controversial. MATERIAL OF STUDY: We reviewed meta-analyses, scientific societies guidelines, randomized and controlled clinical trials from 1999 to 2016 for a total of 146,231 patients. We included in our analysis the accuracy of different tools of investigation, the reliability of the endoscopic biopsies and compared the results of the various LE and TAR...
March 27, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28281474/combined-laparoscopic-and-transanal-total-mesorectal-excision-for-rectal-cancer-initial-experience-and-early-results
#11
Morten Holt Thomsen, Henrik Ovesen, Jens Ravn Eriksen
INTRODUCTION: Incomplete specimens resulting in residual mesorectum in the patient and an increased risk of local recurrence remains a problem. We have introduced transanal-total mesorectal excision (Ta-TME) in our department to potentially overcome this problem due to more direct access to the lower pelvis in patients undergoing TME for rectal cancer and this article presents our initial experience with the new procedure. MATERIALS AND METHODS: Patients with a T1-T3 mid or low rectal cancer eligible for TME or intersphincteric abdominoperineal excision were selected for a combined transanal and transabdominal laparoscopic resection...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28265766/combined-transanal-total-mesorectal-excision-tatme-with-laparoscopic-instruments-and-abdominal-robotic-surgery-in-rectal-cancer
#12
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
#13
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/28206939/the-ferguson-operating-anoscope-for-resection-of-t1-rectal-cancer
#14
Kristin C Turza, Thomas Brien, Steven Porbunderwala, Christopher M Bell, Shauna Lorenzo-Rivero, Richard A Moore, Eric C Nelson, J Daniel Stanley
The Ferguson Operating Anoscope (FOA) is a surgical instrument, which can facilitate transanal excision of appropriate rectal tumors within 15 cm of the anal verge. Previous work showed low recurrence (4.3%) for favorable T1 tumors (no lymphovascular invasion, well/moderate differentiation, negative margins). This follow-up study evaluates outcomes in rectal cancer excised with FOA at a tertiary care center. T1 rectal cancer patients were identified in a prospectively maintained database. Tumor pathology and patient characteristics were reviewed...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28150422/successful-restoration-of-fecal-continence-using-sacral-nerve-stimulation-following-chemoradiation-and-transanal-excision-of-an-anal-melanoma-with-partial-internal-anal-sphincter-resection-a-case-report
#15
Tyler Cameron Tolopka, Craig A Messick
OBJECTIVE: This case report provides evidence for our hypothesis that use of a sacral nerve stimulator may be considered in patients with fecal incontinence (FI) following chemoradiation and transanal operations in the setting of cancer including partial internal sphincter resections. MATERIALS AND METHODS: A 57-year-old female with a history of anal melanoma was treated with neoadjuvant chemoradiation followed by wide local, transanal tumor excision with partial internal anal sphincter resection that resulted in ≥2 full fecal incontinent episodes/week with gas, liquid, and solid stool leakage ≥10/day requiring pad changes...
February 1, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28144126/transanal-endoscopic-operation-for-benign-rectal-lesions-and-t1-carcinoma
#16
Mathieu D'Hondt, Emi Yoshihara, Lieven Dedrye, Koen Vindevoghel, Frederiek Nuytens, Hans Pottel
BACKGROUND AND OBJECTIVES: Transanal endoscopic operation (TEO) is a minimally invasive technique used for local excision of benign and selected malignant rectal lesions. The purpose of this study was to investigate the feasibility, safety, and oncological outcomes of the procedure and to report the experience in 3 centers. METHODS: Retrospective review of a prospectively collected database was performed of all patients with benign lesions or ≤cT1N0 rectal cancer who underwent TEO with curative intent at 3 Belgian centers (2012 through 2014)...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28139235/functional-outcomes-after-disc-excision-in-deep-endometriosis-of-the-rectum-using-transanal-staplers-a%C3%A2-series-of-111-consecutive-patients
#17
Horace Roman, Basma Darwish, Valérie Bridoux, Rachid Chati, Sabrina Kermiche, Julien Coget, Emmanuel Huet, Jean-Jacques Tuech
OBJECTIVE: To assess the postoperative outcomes of patients with rectal endometriosis managed by disc excision using transanal staplers. DESIGN: Prospective study using data recorded in the CIRENDO database (NCT02294825). SETTING: University tertiary referral center. PATIENT(S): A total of 111 consecutive patients managed between June 2009 and June 2016. INTERVENTION(S): We performed rectal disc excision using two different transanal staplers: [1] the Contour Transtar stapler (the Rouen technique); and [2] the end to end anastomosis circular transanal stapler...
April 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28099070/laparoscopic-rectal-dissection-assisted-by-transanal-endoluminal-videoendoscopy-through-a-blunt-tip-trocar
#18
Emanuele Asti, Andrea Lovece, Luigi Bonavina
BACKGROUND AND AIMS: Laparoscopic resection is a well-established approach for colorectal cancer surgery. In patients with rectal cancer treated by neoadjuvant chemoradiotherapy, it may be difficult to identify a clear safety margin for endostapling and subsequent anastomosis. We designed an innovative technical approach to assist colorectal anastomosis in these patients. TECHNIQUE: A four-trocar laparoscopic approach is used. After exploration of the abdominal cavity, the left colic flexure is completely mobilized...
January 18, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28092017/transanal-total-mesorectal-excision-for-a-large-leiomyosarcoma-at-the-lower-rectum-a-case-report-and-literature-review
#19
Nobuaki Hoshino, Koya Hida, Kenji Kawada, Takaki Sakurai, Yoshiharu Sakai
BACKGROUND: Rectal leiomyosarcoma (LMS) is an extremely rare disease. Previously, LMS was not properly distinguishable from gastrointestinal stromal tumor (GIST) until c-kit, a characteristic marker of GIST, was discovered in 1998. No standard therapeutic strategy for gastrointestinal LMS has been established except for surgical resection because of its rarity. Rectal LMS is often accompanied by symptoms, which can enable detection at a small size. However, when a large LMS is detected at the lower rectum, it is difficult to excise due to the narrow pelvic space...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28044239/transanal-total-mesorectal-excision-tatme-for-rectal-cancer-effects-on-patient-reported-quality-of-life-and-functional-outcome
#20
T W A Koedam, G H van Ramshorst, C L Deijen, A K E Elfrink, W J H J Meijerink, H J Bonjer, C Sietses, J B Tuynman
BACKGROUND: Transanal total mesorectal excision (TaTME) has rapidly become an important component of the treatment of rectal cancer surgery. Cohort studies have shown feasibility concerning procedure, specimen quality and morbidity. However, concerns exist about quality of life and ano(neo)rectal function. The aim of this study was to prospectively evaluate quality of life in patients following TaTME for rectal cancer with anastomosis. METHODS: Consecutive patients who underwent restorative TaTME surgery for rectal adenocarcinoma in an academic teaching center with tertiary referral function were evaluated...
January 2017: Techniques in Coloproctology
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