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Transanal excision

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https://www.readbyqxmd.com/read/29791978/combination-of-endoscopic-submucosal-dissection-and-transanal-minimally-invasive-surgery-for-the-resection-of-early-rectal-cancer-with-fibrosis-after-prior-partial-excision
#1
Sung Hoo Kim, Dong Hoon Yang, Seok-Byung Lim
Endoscopic submucosal dissection is an effective procedure for treating non-invasive colorectal tumors. However, in cases of severe fibrosis, endoscopic submucosal dissection may be technically difficult, leading to incomplete resection. Here, we describe the case of a 74-year-old man who had early rectal cancer along with severe submucosal fibrosis caused by prior local excision. Combination treatment with endoscopic submucosal dissection and transanal minimally invasive surgery successfully enabled complete resection...
May 23, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29791891/transanal-endoscopic-microsurgery-with-or-without-completion-total-mesorectal-excision-for-t2-and-t3-rectal-carcinoma
#2
Jeroen W A Leijtens, Thomas W A Koedam, Wernard A A Borstlap, Monique Maas, Pascal G Doornebosch, Tom M Karsten, Eric J Derksen, Laurents P S Stassen, Camiel Rosman, Eelco J R de Graaf, André J A Bremers, Jeroen Heemskerk, Geerard L Beets, Jurriaan B Tuynman, Kevin L J Rademakers
AIM: Transanal endoscopic microsurgery (TEM) is used for the resection of large rectal adenomas and well or moderately differentiated T1 carcinomas. Due to difficulty in preoperative staging, final pathology may reveal a carcinoma not suitable for TEM. Although completion total mesorectal excision is considered standard of care in T2 or more invasive carcinomas, this completion surgery is not always performed. The purpose of this article is to evaluate the outcome of patients after TEM-only, when completion surgery would be indicated...
May 23, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29789768/radiological-and-clinical-findings-following-rectal-contact-x-ray-brachytherapy-papillon-technique-how-to-assess-response
#3
Matt J D Dunstan, Tim A Rockall, Kate Potter, Alexandra J Stewart
Purpose: Rectal contact X-ray brachytherapy (Papillon radiotherapy) has recently received approval from the National Institute for Health and Care Excellence. In particular, it is suitable for elderly patients who are high-risk for a major operation, but it may also be undertaken for patients who wish to avoid a stoma. It is imperative to be able to identify clinical response or tumor regrowth on surveillance magnetic resonance imaging (MRI) and sigmoidoscopy. This article aims to help clinicians to interpret MRIs and endoscopic appearances following Papillon radiotherapy...
April 2018: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/29777788/modified-transanosphincteric-york-mason-repair-of-non-radiated-rectourinary-fistulae-patient-reported-fecal-continence-outcomes
#4
Maxim J McKibben, Joceline S Fuchs, Alexander T Rozanski, Jeremy M Scott, Craig Olson, Farshid Araghizadeh, Allen F Morey
OBJECTIVES: To review our experience with the modified York Mason (MYM) procedure in treatment of rectourinary fistulae (RUF), and to assess fecal continence using patient reported measures. METHODS: Retrospective review was performed for patients who underwent MYM repair of non-radiated RUF with gluteal free fat graft from 2008 to 2016 at a single institution. Success was defined as resolution of fistula without need for further surgery. The Cleveland Clinic-Florida Wexner Fecal Incontinence Score (CCFFIS) and Patient Global Impression of Improvement (PGI-I) surveys were administered by phone...
May 16, 2018: Urology
https://www.readbyqxmd.com/read/29771810/transanal-total-mesorectal-excision-vs-laparoscopic-total-mesorectal-excision-in-the-treatment-of-low-and-middle-rectal-cancer-a-propensity-score-matching-analysis
#5
Roberto Persiani, Alberto Biondi, Francesco Pennestrì, Valeria Fico, Veronica De Simone, Flavio Tirelli, Francesco Santullo, Domenico D'Ugo
BACKGROUND: Transanal total mesorectal excision is a novel and promising technique in the treatment of low and middle rectal cancer. OBJECTIVE: This study aimed to compare the safety and feasibility of transanal total mesorectal excision versus laparoscopic total mesorectal excision. DESIGN: This was a retrospective study using propensity score matching analysis. SETTINGS: This study was conducted in a single high-volume university hospital...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29771806/supine-bottom-up-extralevator-abdominoperineal-excision-with-primary-perineal-approach
#6
Cécile de Chaisemartin, Diane Mège, Jean Michel Durey, Hélène Meillat, Jean Robert Delpero, Bernard Lelong
To improve poor oncological outcomes of conventional abdominoperineal excision (APE), an extralevator abdominoperineal excision has been developed. This technique is associated with a larger pelvic floor defect and needs position changing and flap reconstruction, which increase operating time and morbidity without proof of best oncological results. Based on the recent development of transanal approaches for retrograde transanal mesorectal excision, we describe a novel approach for APE by a primary perineal dissection...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29762145/a-succinct-critical-appraisal-of-indications-to-transanal-total-mesorectal-excision
#7
Mahir Gachabayov, Alexandra Chudner, Roberto Bergamaschi
No abstract text is available yet for this article.
May 14, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29740919/transanal-total-mesorectal-excision-for-locally-advanced-pt4b-rectal-cancers
#8
Chun Han Nigel Tan, Kuok Chung Lee, Wai Kit Cheong, Choon Seng Chong
No abstract text is available yet for this article.
May 8, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29725785/salvage-tme-following-tem-a-possible-indication-for-tatme
#9
F Letarte, M Raval, A Karimuddin, P T Phang, C J Brown
BACKGROUND: Salvage surgery after transanal endoscopic microsurgery (TEM) has shown mixed results. Transanal total mesorectal excision (TaTME) might be advantageous in this population. The aim of this study was to assess the short-term oncologic and operative outcomes of salvage surgery after TEM, comparing TaTME to conventional salavge TME (sTME). METHODS: Consecutive patients treated with salvage surgery after TEM were identified. Patients who underwent TaTME were compared to those who had conventional sTME...
May 4, 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29724664/cognitive-skills-training-in-digital-era-a-paradigm-shift-in-surgical-education-using-the-tatme-model
#10
REVIEW
Joep Knol, Deborah S Keller
Surgical competence is a complex, multifactorial process, requiring ample time and training. Optimal training is based on acquiring knowledge and psychomotor and cognitive skills. Practicing surgical skills is one of the most crucial tasks for both the novice surgeon learning new procedures and surgeons already in practice learning new techniques. Focus is placed on teaching traditional technical skills, but the importance of cognitive skills cannot be underestimated. Cognitive skills allow recognizing environmental cues to improve technical performance including situational awareness, mental readiness, risk assessment, anticipating problems, decision-making, adaptation, and flexibility, and may also accelerate the trainee's understanding of a procedure, formalize the steps being practiced, and reduce the overall training time to become technically proficient...
April 30, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29685761/impact-of-an-institutional-change-from-routine-to-highly-selective-diversion-of-a-low-anastomosis-after-tme-for-rectal-cancer
#11
R D Blok, R Stam, E Westerduin, W A A Borstlap, R Hompes, W A Bemelman, P J Tanis
INTRODUCTION: The need for routine diverting ileostomy following restorative total mesorectal excision (TME) is increasingly debated as the benefits might not outweigh the disadvantages. This study evaluated an institutional shift from routine (RD) to highly selective diversion (HSD) after TME surgery for rectal cancer. MATERIALS AND METHODS: Patients having TME with primary anastomosis and HSD for low or mid rectal cancer between December 2014 and March 2017 were compared with a historical control group with RD in the preceding period since January 2011...
April 12, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29682706/-risk-factors-of-anastomotic-leakage-in-the-procedures-of-trans-abdominal-and-transanal-total-mesorectal-excision-for-rectal-cancer
#12
Hongwei Yao, Zhongtao Zhang
Anastomotic leakage is one of the most serious complications following traditional trans-abdominal total mesorectal excision of rectal cancer. Anastomotic leakage not only affects the postoperative recovery of patients, but also affects their long-term survival. Transanal total mesorectal excision(taTME) is a new surgical procedure developed in recent years. Its anastomosis is different from traditional trans-abdominal total mesorectal excision surgery. The risk of anastomotic leakage and related risk factors are also different...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29668359/laparoscopic-total-mesorectal-excision-following-transanal-endoscopic-microsurgery-for-rectal-cancer
#13
Nidal Issa, Yaniv Fenig, Rachel Gingold-Belfer, Muhammad Khatib, Wisam Khoury, Lea Wolfson, Hemda Schmilovitz-Weiss
BACKGROUND: Patients' selection for transanal endoscopic microsurgery (TEM) depends on diagnostic modalities; however, there are still some limitations in the preoperative diagnosis of rectal lesions, and in some reports, up to third of the adenomas resected by TEM were found to be adenocarcinoma; therefore, salvage radical resection (RR) remains necessary for achieving oncological resection. Salvage RR may encounter some technical problems as the violation of the mesorectum and the scar formation...
April 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29658675/local-excision-for-rectal-cancer-a-minimally-invasive-option
#14
Marco E Allaix, Alberto Arezzo, Milica Nestorović, Bianca Galosi, Mario Morino
Transanal excision (TAE) with conventional retractors and transanal endoscopic microsurgery (TEM) are two well established minimally invasive surgical options for the treatment of selected rectal cancers. TEM is nowadays considered the standard of care for the transanal excision of rectal tumors, since it is associated with significantly better quality of excision and lower rates of recurrence than TAE. When compared with rectal resection and total mesorectal excision, TEM has lower postoperative morbidity and better functional outcomes, with similar long-term survival rates in selected early rectal cancers...
April 13, 2018: Minerva Chirurgica
https://www.readbyqxmd.com/read/29657063/does-previous-transanal-excision-for-early-rectal-cancer-impair-surgical-outcomes-and-pathologic-findings-of-completion-total-mesorectal-excision-results-of-a-systematic-review-of-the-literature
#15
Y Eid, A Alves, J Lubrano, B Menahem
BACKGROUND: Transanal excision (TAE) is increasingly used in the treatment of early rectal cancer because of lower rate of both postoperative complications and postsurgical functional disorders as compared with total mesorectal excision (TME) OBJECTIVE: To compare in a meta-analysis surgical outcomes and pathologic findings between patients who underwent TAE followed by completion proctectomy with TME (TAE group) for early rectal cancer with unfavorable histology or incomplete resection, and those who underwent primary TME (TME group)...
April 12, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29651788/sphincter-preserving-surgery-for-recurrent-pelvic-malignancy-using-a-hybrid-procedure-of-open-laparotomy-and-transanal-endoscopic-approach
#16
Seiji Ishiguro, Shunichiro Komatsu, Kenichi Komaya, Takuya Saito, Takashi Arikawa, Kenichiro Kaneko, Tsuyoshi Sano
BACKGROUND: Surgery for the treatment of recurrent pelvic malignancy is challenging. Sphincter-preserving surgery (SPS) has been applied in limited cases. Transanal endoscopic approach (TEA) has been used for primary rectal cancer, predominantly for hybrid transabdominal-transanal total mesorectal excision. Here, we describe the use of TEA as a hybrid approach in a case of recurrent ovarian cancer. CASE PRESENTATION: A 59-year-old woman had recurrence of serous ovarian adenocarcinoma in the vaginal stump, near the site of anastomosis from a rectal resection 18 months previously...
April 12, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29624549/phase-ii-clinical-trial-to-evaluate-the-efficacy-of-transanal-endoscopic-total-mesorectal-excision-for-rectal-cancer
#17
RANDOMIZED CONTROLLED TRIAL
Sung Chan Park, Dae Kyung Sohn, Min Jung Kim, Hee Jin Chang, Kyung Su Han, Jong Hee Hyun, Jungnam Joo, Jae Hwan Oh
BACKGROUND: Total mesorectal excision has become the standard treatment for rectal cancer, and several investigators have shown that a transanal approach is a feasible option. OBJECTIVE: This study aimed to evaluate the efficacy of transanal endoscopic total mesorectal excision in patients with rectal cancer. DESIGN: This study was a prospective, single-arm phase II trial. It was registered on clinicaltrials.gov under identifier NCT02406118...
May 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29594165/lower-gastrointestinal-surgery-robotic-surgery-versus-laparoscopic-procedures
#18
REVIEW
Julia-Kristin Baukloh, Daniel Perez, Matthias Reeh, Matthias Biebl, Jakob R Izbicki, Johann Pratschke, Felix Aigner
Introduction: For a long time, the comprehensive application of minimally invasive techniques in lower gastrointestinal (GI) surgery was substantially impaired by inherent anatomical and technical complexities. Recently, several new techniques such as robotic operating platforms and transanal total mesorectal excision (taTME) have revolutionized the minimally invasive approach. This review aims to depict the current state of the art and evaluates the advantages and drawbacks in regard to perioperative outcome and quality of oncological resection...
February 2018: Visceral Medicine
https://www.readbyqxmd.com/read/29588809/evolution-of-transanal-total-mesorectal-excision-for-rectal-cancer-from-top-to-bottom
#19
REVIEW
Sameh Hany Emile, F Borja de Lacy, Deborah Susan Keller, Beatriz Martin-Perez, Sadir Alrawi, Antonio M Lacy, Manish Chand
The gold standard for curative treatment of locally advanced rectal cancer involves radical resection with a total mesorectal excision (TME). TME is the most effective treatment strategy to reduce local recurrence and improve survival outcomes regardless of the surgical platform used. However, there are associated morbidities, functional consequences, and quality of life (QoL) issues associated with TME; these risks must be considered during the modern-day multidisciplinary treatment for rectal cancer. This has led to the development of new surgical techniques to improve patient, oncologic, and QoL outcomes...
March 27, 2018: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29581623/a-case-of-local-recurrence-of-t1-rectal-cancer-10-years-after-transanal-excision
#20
Hideharu Tanaka, Koji Komori, Takashi Kinoshita, Taihei Oshiro, Seiji Ito, Tetsuya Abe, Yoshiki Senda, Kazunari Misawa, Yuichi Ito, Norihisa Uemura, Seiji Natsume, Eiji Higaki, Akira Ouchi, Masayuki Tsutsuyama, Takahiro Hosoi, Itaru Shigeyoshi, Byonggu An, Tomoyuki Akazawa, Daisuke Hayashi, Tairin Uchino, Aina Kunitomo, Yasuhiro Shimizu
We report a case of a patient with T1 rectal cancer, which recurred locally after 10 years from the primary operation. A 78-year-old woman was diagnosed with rectal cancer. Transanal excision (TAE) was performed in December 2006. The pathological findings revealed stage I rectal cancer [tub2>muc, pSM (2,510 µm), ly0, v0, pHM0, pVM0]. Because she did not opt for additional treatment, she received follow-up examination. After approximately 10 years from the primary operation, she presented to her physician, complaining of melena, and she was referred to our hospital again in November 2016...
February 2018: Nagoya Journal of Medical Science
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