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Transanal excision

X Serra-Aracil, A Zárate, L Mora, S Serra-Pla, A Pallisera, J Bonfill, J Bargalló, A Pando, S Delgado, E Balleteros, C Pericay
PURPOSE: Compared with the open approach, laparoscopic total mesorectal excision (TME) achieves faster patient recovery, reduces morbidity rates, and shortens hospital stay. However, in laparoscopic low anterior resection (L-LAR), conversion to open surgery is required in almost 20% of cases. Transanal TME (Ta-TME) combined with laparoscopy, also called hybrid natural orifice transluminal endoscopic surgery (NOTES), is a less invasive procedure that can overcome some of the limitations of laparoscopic rectal surgery...
March 16, 2018: International Journal of Colorectal Disease
Ki Young Lee, Jung Kyoung Shin, Yoon Ah Park, Seong Hyeon Yun, Jung Wook Huh, Yong Beom Cho, Hee Cheol Kim, Woo Yong Lee
Purpose: This study aimed to compare short-term postoperative and oncologic outcomes of a transanal endoscopic total mesorectal excision (TME) to those of a transabdominal robotic TME. Methods: A total of 62 patients with rectal cancer underwent transanal (n = 26) or robotic (n = 36) TME between June 2013 and December 2014. After case-matching by tumor location and TNM stage, 45 patients were included for analysis. The median follow-up period was 21.3 months. Operative, histopathologic and postoperative outcomes and recurrences were analyzed...
February 2018: Annals of Coloproctology
Hyuk Hur
No abstract text is available yet for this article.
February 2018: Annals of Coloproctology
Hong-Peng Jiang, Yan-Sen Li, Bo Wang, Chang Wang, Fan Liu, Zhan-Long Shen, Ying-Jiang Ye, Shan Wang
BACKGROUND: Since 2010, comparative studies on transanal and laparoscopic total mesorectal excision (TME) have been published and it remains unclear about the oncological benefit from transanal total mesorectal excision (taTME). METHODS: We have searched English databases to identify all taTME studies published between January 2010 and August 2017. Pathological outcomes included circumferential resection margin (CRM), positive CRM (< 1 M), length of distal resection margin (DRM), positive DRM, quality of mesorectum (complete mesorectum), harvested lymph node, and length of the specimen...
February 20, 2018: Surgical Endoscopy
Niels Bjørn, Lars Rasmussen, Niels Qvist, Sönke Detlefsen, Mark Bremholm Ellebæk
INTRODUCTION: The diagnosis of Hirschsprung's disease (HD) relies on the histological demonstration of aganglionosis in the bowel wall. Biopsies may be obtained by rectal suction biopsy (RSB) or by transanal full-thickness excision biopsy (FTB). The objective of the present study was to evaluate the frequency of complications and inconclusive biopsies after FTB in children referred with suspicion of HD. The secondary objective was to calculate the frequency of proven aganglionosis. METHODS: A retrospective chart review was performed of all patients under the age of 16years who underwent transanal FTB during the time period of 2008-2014...
January 31, 2018: Journal of Pediatric Surgery
K C Ratnatunga, R M Ranatunga, B D Gamage
No abstract text is available yet for this article.
December 26, 2017: Ceylon Medical Journal
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
G R Wynn, R C T Austin, R W Motson
AIM: To document the outcomes of surgeons attending a cadaveric simulation course designed to provide an introduction to transanal total mesorectal excision (TaTME). METHOD: This was a prospective observational study documenting the outcomes from classroom and wet lab activities. Follow up questionnaires were used to monitor clinical activity after the course. RESULTS: Outcomes of 65 delegates from 12 different countries attending 7 cadaveric simulation courses are described...
January 25, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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
Hideaki Kawakita, Kenji Katsumata, Yoshiaki Osaka, Hitoshi Saito, Kazuhiko Tamura, Tomoki Shirota, Kenta Kasahara, Minoru Kuwabara, Masatoshi Shigoka, Takaaki Matsudo, Masanobu Enomoto, Tetsuo Ishizaki, Masayuki Hisada, Kazuhiko Kasuya, Akihiko Tsuchida
A46 -year-old man developed ulcerative colitis at the age of 19 years. Although the colitis was medically treated, it relapsed and repeated over time. Periodic lower gastrointestinal endoscopy revealed lower rectal cancer, and he was referred to our department of surgery. Previous steroid therapy induced diabetes, and he was obese, with a height of 170.3 cm, weight of 89.6 kg, and BMI of 30.89 kg/m2, indicating that laparoscopic dissection near the anus would be difficult to perform. Therefore, the patient was scheduled for transanal minimally invasive surgery(TAMIS)...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Jianping Wang
Radical surgeries and(neo) adjuvant therapies have significantly prolonged survival of patients with colorectal cancer. Microinvasive surgery and function preservation become more important with the prerequisite of R0 resection. As for colorectal cancer, long term survival after laparoscopic curative surgery is proved non-inferior to its open counterpart. The new transanal approach of total mesorectal excision, while avoiding abdominal incision for extraction, may as well improve surgical quality. Local excision and the "watch and wait" strategy, though attractive for organ-preservation, are undermined by suboptimal clinical and radiographic assessment of lymph node and treatment response, respectively...
January 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Li-Jen Kuo, James Chi-Yong Ngu, Chia-Che Chen
Transanal total mesorectal excision (taTME) has been proposed to overcome the limitations of laparoscopic TME. The robotic surgical platform has already established its benefits in providing superior ergonomics, and the purported advantages of taTME may play less important a role in the era of robots.
January 19, 2018: International Journal of Colorectal Disease
Joel Shapiro, Joris J J C de Graaf, Pascal G Doornebosch, Maarten Vermaas, Eelco J R de Graaf
No abstract text is available yet for this article.
February 2018: Diseases of the Colon and Rectum
Lawrence Lee, Ashley Althoff, Kimberley Edwards, Matthew R Albert, Sam B Atallah, Iain A Hunter, James Hill, John R T Monson
BACKGROUND: The management of the rectal wall defect after local excision of rectal neoplasms remains controversial, and the existing data are equivocal. OBJECTIVE: This study aimed to determine the effect of open versus closed defects on postoperative outcomes after local excision of rectal neoplasms. DESIGN: Data from 3 institutions were analyzed. Propensity score matching was performed in one-to-one fashion to create a balanced cohort comparing open and closed defects...
February 2018: Diseases of the Colon and Rectum
Marta Penna, Roel Hompes, Steve Arnold, Greg Wynn, Ralph Austin, Janindra Warusavitarne, Brendan Moran, George B Hanna, Neil J Mortensen, Paris P Tekkis
OBJECTIVE: To determine the incidence of anastomotic-related morbidity following Transanal Total Mesorectal Excision (TaTME) and identify independent risk factors for failure. BACKGROUND: Anastomotic leak and its sequelae are dreaded complications following gastrointestinal surgery. TaTME is a recent technique for rectal resection, which includes novel anastomotic techniques. METHODS: Prospective study of consecutive reconstructed TaTME cases recorded over 30 months in 107 surgical centers across 29 countries...
January 5, 2018: Annals of Surgery
Dimitrios Giannoulopoulos, Constantinos Nastos, Maria Gavriatopoulou, Antonios Vezakis, Dionysios Dellaportas, Ira Sotirova, Georgios Giokas, Georgios Polymeneas, Theodosios Theodosopoulos
PURPOSE OF THE STUDY: The current gold standard for contemporary treatment of rectal cancer is total mesorectal excision (TME), achieving excellent local disease control and low recurrence rates. However, TME may be associated with postoperative mortality and quality of life deterioration. Therefore, the need to develop less radical treatment strategies has emerged. Transanal minimally invasive surgery (TAMIS) is currently indicated only for early rectal cancer. However, local excision following chemoradiation has yielded promising clinical outcomes in selected cases with more advanced disease...
January 9, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
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
Daniel Perez, Nathaniel Melling, Matthias Biebl, Matthias Reeh, Julia-Kristin Baukloh, Jameel Miro, Adam Polonski, Jakob R Izbicki, Belinda Knoll, Johann Pratschke, Felix Aigner
BACKGROUND: Robotic low anterior resection (RLAR) and transanal total mesorectal excision (TaTME) are novel surgical techniques for resection of rectal cancer. To our knowledge, no data exist on direct comparison of these procedures in terms of oncological or functional parameters. METHODS: 60 RLAR and 55 TaTME for rectal cancer were compared in respect to patient characteristics, clinicopathological parameters, intraoperative and perioperative results and anatomopathological outcome...
February 2018: European Journal of Surgical Oncology
Niccolò Petrucciani, Aleix Martínez-Pérez, Giorgio Bianchi, Riccardo Memeo, Francesco Brunetti, Nicola De' Angelis
INTRODUCTION: In the last decades, the use of minimally invasive surgery has dramatically increased for the treatment of rectal cancer. However, no clear evidence exists on the role of laparoscopy for locally advanced rectal cancer, especially for cT4 tumors, after neoadjuvant therapy. EVIDENCE ACQUISITION: A literature search was performed on Embase, Medline, and Cochrane databases to identify relevant studies published up to November 2017 analyzing the outcomes of laparoscopic surgery for locally advanced rectal cancer...
December 14, 2017: Minerva Chirurgica
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