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Transanal excision

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https://www.readbyqxmd.com/read/28722085/-anatomical-planes-and-landmarks-of-transanal-total-mesorectal-excision-for-rectal-cancer-and-prophylaxis-of-intraoperative-complications
#1
Zhanlong Shen, Yingjiang Ye, Shan Wang
Total mesorectal excision (TME) is a mile-stone procedure in the history of rectal cancer surgery, but the exposure of surgical field of distal rectum is usually poor in patients with male, obese and narrow pelvis, which may lead to tumor residue and relative complications. Recently, a new technique called transanal TME (taTME) is considered to solve the above problems, but most medical centers are still in the learning curve of this procedure. Therefore, anatomical planes and landmarks of taTME for rectal cancer and prophylaxis of intraoperative complications are induced in this paper, which includes posterior plane: angle of anus and distal mesorectum and bleeding of mesorectum; rectosacral fascia and presacral bleeding; lateral and posterior-lateral plane: posterior branches of pelvic plexus and damage of anal function; anterior plane: vessel branches of neurovascular bundle and bleeding...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28707106/robotic-transanal-surgery-rtas-with-utilization-of-a-next-generation-single-port-system-a-cadaveric-feasibility-study
#2
J Marks, S Ng, T Mak
PURPOSE: Transanal surgery remains both an innovative approach to rectal pathology and a demonstrated technical challenge. Improved technology using a single-port system robotic platform (SPS) offers a promising option for this surgery. METHODS: SPS robotic system was utilized to perform submucosal, full-thickness and cylindrical excision on four cadavers. Operative performance and surgeon fatigue were measured. RESULTS: On all types of resections, the SPS system performed well...
July 14, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28702861/outcomes-of-a-single-surgeon-based-transanal-total-mesorectal-excision-tatme-for-rectal-cancer
#3
Antonio Caycedo-Marulanda, Henry Y Jiang, Erica L Kohtakangas
BACKGROUND: Several studies have shown the transanal total mesorectal excision (TATME) is emerging as a safe and effective technique for proctectomy. The majority of these studies to date, however, is based on procedures done in centers with teams of two surgeons working simultaneously. Few were performed by single-surgeon teams with sizeable case load. The objective of our study was to identify the feasibility and safety of a single-surgeon TATME. METHODS: Chart review of prospectively collected data on 27 patients who underwent TATME at our institution from June 2015 to September 2016 were included in this study...
July 13, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28695225/-transanal-total-mesorectal-excision-tatme-for-primary-rectal-cancer-video-article
#4
REVIEW
W Kneist
Transanal total mesorectal excision (TaTME) is a new surgical technique in the treatment of selected patients with rectal cancer. This manuscript and the accompanying video report with commentary, which is available online, outlines various equipment requirements and step by step aspects of the surgical technique. With respect to the implementation of TaTME particular attention should be paid to the topography and surgical education.
July 10, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28690773/recent-advances-in-the-management-of-rectal-cancer-no-surgery-minimal-surgery-or-minimally-invasive-surgery
#5
REVIEW
Joseph M Plummer, Pierre-Anthony Leake, Matthew R Albert
Over the last decade, with the acceptance of the need for improvements in the outcome of patients affected with rectal cancer, there has been a significant increase in the literature regarding treatment options available to patients affected by this disease. That treatment related decisions should be made at a high volume multidisciplinary tumor board, after pre-operative rectal magnetic resonance imaging and the importance of total mesorectal excision (TME) are accepted standard of care. More controversial is the emerging role for watchful waiting rather than radical surgery in complete pathologic responders, which may be appropriate in 20% of patients...
June 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28682974/complete-transanal-total-mesorectal-excision-for-lower-rectal-cancer
#6
Dai Uematsu, Gaku Akiyama, Takehiko Sugihara, Akiko Magishi, Kojiro Ono, Takuya Yamaguchi, Takayuki Sano
No abstract text is available yet for this article.
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28682454/developing-a-national-colorectal-educational-agenda-a-survey-of-the-acpgbi
#7
N K Francis, N J Curtis, C Weegenaar, P A Boorman, A Brook, G Thorpe, K Keogh, J Grainger, J Davies, J Wheeler, S R Brown, R J Steele, P Dawson
AIM: In order to develop its education agenda, the ACPGBI sought the opinion of its members on current coloproctology training needs. The aims of this study were to canvass multi-disciplinary needs and explore the perceived gaps and barriers to meeting them. METHOD: A learner needs analysis was performed between July 2015 and October 2016. A bespoke electronic survey was sent to 1,453 colorectal health care professionals (ACPGBI membership (1,173), colorectal nurse specialists and allied health professionals (NAHP) (261) and regional chapter-leads (19)) seeking their needs, experiences and barriers to training across the coloproctology disciplines...
July 6, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28675024/are-we-predicting-disease-progress-of-the-rectal-cancer-patients-without-surgery-after-neoadjuvant-chemoradiotherapy
#8
Bo Young Oh, Jung Wook Huh, Woo Yong Lee, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Ho-Kyung Chun
Purpose: There are patients who do not undergo surgery, regardless of tumor response for neoadjuvant chemoradiotherapy (nCRT) in rectal cancer. However, there have been few reports focused on how oncologic outcomes are worse in these patients. We sought to investigate oncologic outcomes for these non-operated patients with rectal cancer after nCRT. Materials and Methods: A total of 1,063 records of patients with rectal cancer who were treated with nCRT from January 2002 to December 2013 were retrospectively reviewed...
July 3, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28664443/vacuum-assisted-early-transanal-closure-of-leaking-low-colorectal-anastomoses-the-clean-study
#9
W A A Borstlap, G D Musters, L P S Stassen, H L van Westreenen, D Hess, S van Dieren, S Festen, E J van der Zaag, P J Tanis, W A Bemelman
INTRODUCTION: Non-healing of anastomotic leakage can be observed in up to 50% after total mesorectal excision for rectal cancer. This study investigates the efficacy of early transanal closure of anastomotic leakage after pre-treatment with the Endosponge(®) therapy. METHODS: In this prospective, multicentre, feasibility study, transanal suturing of the anastomotic defect was performed after vacuum-assisted cleaning of the presacral cavity. Primary outcome was the proportion of patients with a healed anastomosis at 6 months after transanal closure...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28656075/value-of-macrobiopsies-and-transanal-endoscopic-microsurgery-in-the-histological-work-up-of-rectal-neoplasms-a-retrospective-study
#10
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
https://www.readbyqxmd.com/read/28643300/-advantages-and-disadvantages-of-minimally-invasive-surgery-in-colorectal-cancer-surgery
#11
Minhua Zheng, Junjun Ma
Since the emergence of minimally invasive technology twenty years ago, as a surgical concept and surgical technique for colorectal cancer surgery, its obvious advantages have been recognized. Laparoscopic technology, as one of the most important technology platform, has got a lot of evidence-based support for the oncological safety and effectiveness in colorectal cancer surgery Laparoscopic technique has advantages in terms of identification of anatomic plane and autonomic nerve, protection of pelvic structure, and fine dissection of vessels...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28643051/long-term-outcomes-by-a-transanal-approach-to-total-mesorectal-excision-for-rectal-cancer
#12
John H Marks, Elizabeth A Myers, Erik L Zeger, Albert S Denittis, Mounica Gummadi, Gerald J Marks
BACKGROUND: The challenge of performing a good total mesorectal excision (TME) dissection, particularly in the distal 1/3 of the rectum, has spurred interest in new techniques. Robotic surgery is advocated by some, and more recently, a "new" approach, the transanal total mesorectal excision, has been popularized to address this problem. While great interest in this technique exists, little long-term outcome data are available. We have been utilizing a transanal abdominal transanal approach to TME in order to facilitate the distal dissection, and here, we provide our long-term outcomes using this approach in the management of rectal cancer...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28630589/laparoscopic-colorectal-surgery-for-colorectal-polyps-experience-of-ten-years
#13
Audrius Dulskas, Žygimantas Kuliešius, Narimantas E Samalavičius
Background. Laparoscopy or its combination with endoscopy is the next step for "difficult" polyps. The purpose of the paper was to review the outcomes of the laparoscopic approach to the management of "difficult" colorectal polyps. Materials and methods. From 2006 to 2016, 58 patients who underwent laparoscopic treatment for "difficult" polyps that could not be treated by endoscopy at the National Cancer Institute, Lithuania, were included. The demographic data, the type of surgery, length of post-operative stay, complications, and final pathology were reviewed prospectively...
2017: Acta medica Lituanica
https://www.readbyqxmd.com/read/28621181/-advantages-of-transanal-approach-in-low-rectal-cancer-resections
#14
Géza Papp, István Besznyák, Balázs Pörneczi, György Saftics, Attila Bursics
Laparoscopic surgery is proven equal technique to open rectal surgery. Despite advantages, some problems in case of low rectal surgery are existing: visualization of the pelvis, securing safe distal resection margin, preparing single stapled rectal stump with safe conjunction to the colorectal anastomosis. Approximately 500 procedures have been performed worldwide until today by applying Transanal Total Mesorectal Excision (TaTME) technique, which evolved from a combination of laparoscopy and transanal approach...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28614625/modified-sentinel-lymph-node-technique-combined-with-endoluminal-loco-regional-resection-for-the-treatment-of-rectal-tumors-a-fourteen-year-experience
#15
Silvia Quaresima, Alessandro M Paganini, Giancarlo D'Ambrosio, Pietro Ursi, Andrea Balla, Emanuele Lezoche
AIM: After Endoluminal Loco-Regional Resection (ELRR) by Transanal Endoscopic Microsurgey (TEM) the N parameter may remain undefined. Nucleotide-Guided Mesorectal Excision (NGME) improves the lymph nodes harvest. The aim of the present study is to evaluate the long term oncological results after ELRR with NGME. METHOD: A total of 57 patients were enrolled over the period January 2001 to June 2015.ed. All patients underwent ELRR by TEM. Prior to surgery, 99m-Technetium-marked nanocolloid was injected in the peritumoral submucosa...
June 14, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28614168/glove-port-transanal-excision-of-rectal-tumors-an-alternative-method-for-rectal-tumor-excision-single-center-experience
#16
Sridhar Dharamavaram, Dimple Sapre, Ahmed M A Mohammed, Krishnamurthy Badrinath
AIM: Transanal minimal invasive surgery has been practiced for several years for excision of rectal tumors however there is no standard consensus about its applications. This minimally invasive approach helps in avoiding major rectal resections and its associated risk of mortality and morbidity.The aim of this study is to describe a single center experience with transanal glove port excision of rectal tumors which are not amenable to colonoscopic excision. MATERIALS AND METHODS: Between the years 2011 and 2014, 9 patients underwent glove port excision of rectal tumors located within 15 cm from the anal verge...
June 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28600594/-minimally-invasive-approaches-for-transanal-surgery
#17
REVIEW
W Kneist
Since the introduction of transanal endoscopic microsurgery (TEM) in the 1980 s, the minimally invasive transanal approach has been a treatment option for selected patients with colorectal diseases. Recently, transanal minimally invasive surgery (TAMIS) was introduced as an alternative technique. TAMIS is a hybrid between TEM and single-port laparoscopy and was followed by introduction of transanal total mesorectal excision (TaTME). Although the TaTME experience remains preliminary, it appears to be an attractive minimally invasive procedure for carefully selected patients with resectable rectal cancer...
June 9, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28589242/surgery-beyond-the-visible-light-spectrum-theoretical-and-applied-methods-for-localization-of-the-male-urethra-during-transanal-total-mesorectal-excision
#18
S Atallah, A Mabardy, A P Volpato, T Chin, J Sneider, J R T Monson
The risk of urethral injury during transanal total mesorectal excision (taTME) is delineated, and potential risk factors for iatrogenic transection are reviewed. A variety of applied and theoretical techniques can be used by surgeons to diminish the risk of injury in males undergoing this operation. Many of the approaches utilize non-optic media and wavelengths beyond the visible light spectrum which can enhance the surgeon's frame of reference. The aim of the present study was to assess the techniques and theoretical approaches to urethral localization during taTME...
June 6, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28583790/transanal-endoscopic-microsurgery-after-neoadjuvant-radiochemotherapy-for-locally-advanced-extraperitoneal-rectal-cancer
#19
G Rizzo, G Zaccone, M Magnocavallo, C Mattana, D P Pafundi, M A Gambacorta, V Valentini, C Coco
PURPOSE: The aim of this study is to provide a prospective analysis of post-operative and oncological outcomes in patients affected by locally advanced rectal cancer (LARC), who obtained a major/complete clinical response after pre-operative radio-chemotherapy (RCT) and were treated with local excision (LE) by trans-anal endoscopic microsurgery (TEM) to confirm a pathological complete response (pCR) after to neo-adjuvant RCT. METHODS: All patients with LARC treated by pre-operative RCT and full-thickness LE by TEM (2000-2014) were included in the study...
May 25, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28560481/fluorescence-to-highlight-the-urethra-a-human-cadaveric-study
#20
T G Barnes, M Penna, R Hompes, C Cunningham
BACKGROUND: Urethral injury is a complication feared by surgeons performing transanal TME (TaTME) or abdominoperineal excision (APE) procedures. Injury during TaTME occurs when the prostate is inadvertently mobilised or as a direct injury similar to the direct injury during the perineal dissection of APE procedures. We performed a proof of principle study to assess the feasibility of using indocyanine green (ICG) to fluoresce the urethra in human cadavers. METHODS: Indocyanine green at varying doses was mixed with Instillagel and infiltrated into the urethra of male human cadavers...
June 2017: Techniques in Coloproctology
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