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Transanal excision

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https://www.readbyqxmd.com/read/28044239/transanal-total-mesorectal-excision-tatme-for-rectal-cancer-effects-on-patient-reported-quality-of-life-and-functional-outcome
#1
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 2, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28024946/short-and-mid-term-outcomes-after-endoscopic-transanal-or-laparoscopic-transabdominal-total-mesorectal-excision-for-low-rectal-cancer-a-single-institutional-case-control-study
#2
Bernard Lelong, Hélène Meillat, Christophe Zemmour, Flora Poizat, Jacques Ewald, Diane Mege, Jean Claude Lelong, Jean Robert Delpero, Cécile de Chaisemartin
BACKGROUND: Transabdominal laparoscopic proctectomy for rectal cancer was associated with post-operative recovery improvement. Early studies showed favourable short-term results of endoscopic transanal proctectomy with low conversion rates to an open procedure. We aimed to compare efficacy, morbidity, and functional outcomes of endoscopic transanal proctectomy (ETAP) to standard laparoscopic proctectomy (LAP) for low rectal cancer. STUDY DESIGN: From 2008 to 2013, 72 consecutive patients received proctectomy and coloanal manual anastomosis for low rectal adenocarcinoma...
December 23, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28011978/what-is-the-best-tool-for-transanal-endoscopic-microsurgery-tem-a-case-matched-study-in-74-patients-comparing-a-standard-platform-and-a-disposable-material
#3
Diane Mege, Valérie Bridoux, Léon Maggiori, Jean-Jacques Tuech, Yves Panis
PURPOSE: Transanal endoscopic microsurgery (TEM) is the gold standard for local excision of rectal lesions, but no study exists concerning the best material. The objective was to compare TEM using a disposable material vs a standard platform through a case-matched study. METHODS: Patients who underwent TEM for rectal neoplasms were identified from prospective databases in two tertiary referral centers and matched according to four criteria (sex, tumor location, size, distance from the anal verge): TEM using a disposable material (GelPoint Applied®; group A) and TEM using a standard TEO® platform (Karl Storz, Tuttlingen, Germany; group B)...
December 24, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28000657/combined-laparoscopic-and-transanal-total-mesorectal-excision-for-rectal-cancer-initial-experience-and-early-results
#4
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...
December 21, 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27997526/organ-preservation-with-local-excision-or-active-surveillance-following-chemoradiotherapy-for-rectal-cancer
#5
B Creavin, E Ryan, S T Martin, A Hanly, P R O'Connell, K Sheahan, D C Winter
BACKGROUND: Organ preservation has been proposed as an alternative to radical surgery for rectal cancer to reduce morbidity and mortality, and to improve functional outcome. METHODS: Locally advanced non-metastatic rectal cancers were identified from a prospective database. Patients staged ⩾T3 or any stage N+ were referred for neoadjuvant chemoradiotherapy (CRT) (50-54 Gy and 5-fluorouracil), and were reassessed 6-8 weeks post treatment. An active surveillance programme ('watch and wait') was offered to patients who were found to have a complete endoluminal response...
December 20, 2016: British Journal of Cancer
https://www.readbyqxmd.com/read/27990592/combined-notes-total-mesorectal-excision-and-single-incision-laparoscopy-principles-for-conservative-proctectomy-a-single-centre-study
#6
H Meillat, C de Chaisemartin, F Poizat, E Bories, R Fara, J R Delpero, B Lelong
BACKGROUND: Surgery for low rectal cancer remains a challenge when a standard laparoscopic approach is used. Transanal endoscopic total mesorectal excision (TME) has been shown to be feasible and to be associated with a low conversion rate. Combining the transanal and transabdominal single-port approaches (with an abdominal single port implanted in the future stoma and extraction site) could allow TME with minimal wound trauma, low morbidity, and faster recovery. The aim of the current study was to assess the short- and mid-term results of this technique...
December 19, 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27934790/abdomino-endoscopic-perineal-excision-of-the-rectum-for-benign-and-malignant-pathology-technique-considerations-for-true-transperineal-verus-transanal-total-mesorectal-excision-endoscopic-proctectomy
#7
Hazar Al Furajii, Niall Kennedy, Ronan A Cahill
PURPOSE: Transanal minimally invasive surgery using single port instrumentation is now well described for the performance of total mesorectal excision with restorative colorectal/anal anastomosis most-often in conjunction with transabdominal multiport assistance. While non-restorative abdomino-endoscopic perineal excision of the anorectum is conceptually similar, it has been less detailed in the literature. METHODS: Consecutive patients undergoing non-restorative ano-proctectomy including a transperineal endoscopic component were analysed...
January 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27914773/transanal-total-mesorectal-excision-tatme-for-rectal-cancer-step-by-step-description-of-the-surgical-technique-for-a-two-teams-approach
#8
M C Arroyave, F B DeLacy, A M Lacy
Interest in transanal total mesorectal excision (TaTME) is growing worldwide due to the application of minimally invasive techniques to rectal cancer surgery while maintaining adequate oncologic outcomes. This article presents the standardised and refined technique after performing more than 300 operations at Hospital Clinic of Barcelona.
November 20, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27892668/transanal-endoscopic-microsurgery-in-the-treatment-of-large-rectal-adenomas
#9
Mario Guerrieri, Monica Ortenzi, Giovanni Lezoche, Stefano Mancini, Roberto Ghiselli
BACKGROUND: Transanal endoscopic microsurgery (TEM) is a minimally invasive technique allowing to excise large rectal adenomas by local approach. This study shows the feasibility and results of a long term experience of TEM applied in this field. METHODS: A retrospective investigation was performed in patients affected by rectal adenomas (5-11 cm in diameter) who had undergone transanal endoscopic microsurgery from 1992 to 2015. A series of 207 patients met the inclusion criteria and were analyzed for characteristics, intraoperative and postoperative results and long-term follow-up...
December 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27888300/analysis-of-local-recurrences-after-transanal-endoscopic-microsurgery-for-low-risk-rectal-carcinoma
#10
Theodor Junginger, Ursula Goenner, Mirjam Hitzler, Tong T Trinh, Achim Heintz, Wilfried Roth, Maria Blettner, Daniel Wollschlaeger
AIM: Rates of local recurrence (LR) after transanal endoscopic microsurgery (TEM) for rectal carcinoma vary; the reasons remain unclear. We analyzed LR after TEM for low-risk pT1 (G1/2/X, L0/X) rectal carcinoma to investigate the influence of completeness of resection and occult lymph node metastasis on risk of LR. METHOD: LR location and stage, completeness of resection of primary carcinoma (minimal distance between tumor and resection line ≤1 mm vs >1 mm), and incidence of involved lymph nodes in resected LR specimens were collected, and tumor characteristics of LR were compared with primary carcinoma...
November 25, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27885870/transanal-total-mesorectal-excision-for-restorative-coloproctectomy-in-an-obese-high-risk-patient-with-colitis-associated-carcinoma
#11
Laura Isabel Hanke, Fabian Bartsch, Sebastian Försch, Florian Heid, Hauke Lang, Werner Kneist
Transanal total mesorectal excision (TaTME) offers great potential for the treatment of malign and benign diseases. However, laparoscopic-assisted TaTME in ulcerative colitis has not been described in more than a handful of patients. We present a 47-year-old highly comorbid female patient with an ulcerative colitis-associated carcinoma of the ascending colon and steroid-refractory pancolitis. A two-stage restorative coloproctectomy including right-sided complete mesocolic excision was conducted. The second step consisted of a successful nerve-sparing TaTME and a handsewn ileal pouch-anal anastomosis...
November 25, 2016: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/27885759/transanal-minimally-invasive-rectal-resection-for-deep-endometriosis-a-promising-technique
#12
Stijn L Vlek, Marit C I Lier, Thomas W A Koedam, Ingeborg Melgers, Judith J M L Dekker, Jaap H Bonjer, Velja Mijatovic, Jurriaan B Tuynman
AIM: Surgical management of patients with deep endometriosis (DE) of the rectum is difficult. Inflammation and subsequent adhesions due to DE impede access to the lower pelvis and may lead to complications during laparoscopic low anterior resection (LAR). Transanal minimally invasive surgery (TAMIS) is an alternative to an abdominal approach with potential advantages. The aim of this study was to provide a description of the TAMIS technique and to present the perioperative results of TAMIS and of conventional LAR in patients with DE...
November 25, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27853973/clinical-outcomes-and-case-volume-effect-of-transanal-total-mesorectal-excision-for-rectal-cancer-a-systematic-review
#13
REVIEW
C L Deijen, A Tsai, T W A Koedam, M Veltcamp Helbach, C Sietses, A M Lacy, H J Bonjer, J B Tuynman
Transanal total mesorectal excision (TaTME) has been developed to improve quality of TME for patients with mid and low rectal cancer. However, despite enthusiastic uptake and teaching facilities, concern exists for safe introduction. TaTME is a complex procedure and potentially a learning curve will hamper clinical outcome. With this systematic review, we aim to provide data regarding morbidity and safety of TaTME. A systematic literature search was performed in MEDLINE (PubMed), EMBASE (Ovid) and Cochrane Library...
December 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27846173/current-controversies-in-transanal-surgery-for-rectal-cancer
#14
Jose M Ramirez, Manuela Elia, Elena Cordoba, Jose A Gracia, Vicente Aguilella
Local surgery for rectal tumors has been traditionally limited due to technical issues for lower risk lesions. In the 1980s, Buess described the transanal endoscopic microsurgery (TEM) technique that enabled excision of lesions that were larger and in a higher location. TEM in a short time became the gold standard for the excision of large adenomas and early rectal carcinomas. Since the advent of TEM, and due to advances in minimal invasive technology, new devices and procedures have come to the surgical armamentarium, in many cases with only very slight differences between them...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27837319/functional-outcomes-after-tem-in-patients-with-complete-clinical-response-after-neoadjuvant-chemoradiotherapy
#15
Roberto Ghiselli, Monica Ortenzi, Luca Cardinali, Edlira Skrami, Rosaria Gesuita, Mario Guerrieri
BACKGROUND: In patients who exhibit a complete clinical response after radio-chemotherapy for rectal cancer, the standard surgical approach might constitute overtreatment. The aim of this study is to analyse the outcomes of anorectal function and quality of life after transanal endoscopic microsurgery (TEM) in irradiated patients with complete clinical response. PATIENTS AND METHODS: Between 2007 and 2014, 84 patients who were diagnosed with stage T2-T3-T4 N0 rectal cancer before chemoradiotherapy showed a complete clinical response to neoadjuvant therapy and underwent TEM...
November 11, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27796599/robotic-assisted-colorectal-surgery-in-obese-patients-a-case-matched-series
#16
Jeffrey N Harr, Samuel Luka, Aman Kankaria, Yen-Yi Juo, Samir Agarwal, Vincent Obias
BACKGROUND: Reports demonstrate laparoscopic colorectal surgery in obese patients is associated with higher conversion to laparotomy and complication rates. While several advantages of robotic-assisted surgery have been reported, outcomes in obese patients have not been adequately studied. Therefore, this study compares outcomes of robotic-assisted surgery in non-obese and obese patients. METHODS: A retrospective review of 331 consecutive robotic procedures performed at a single institution between 2009 and 2015 was performed...
October 27, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27777876/transanal-total-mesorectal-excision-myths-and-reality
#17
Nicolas C Buchs, Marta Penna, Alexander L Bloemendaal, Roel Hompes
Transanal total mesorectal excision (TaTME) is a new and promising approach for the treatment of rectal cancer. Whilst the experience is still limited, there are growing evidences that this approach might overcome the limits of standard low anterior resection. TaTME might help to decrease the conversion rate especially in difficult patients, and to improve the pathological results, while preserving the urogenital function. Evaluation of data from large registries and randomized studies should help to draw firmer conclusions...
October 10, 2016: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27757396/feasibility-of-transanal-endoscopic-total-mesorectal-excision-for-rectal-cancer-results-of-a-pilot-study
#18
Jae Hwan Oh, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jong Hee Hyun, Hee Jin Chang, Kyung Su Han, Dae Kyung Sohn
PURPOSE: To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. METHODS: This study enrolled 12 patients with clinically node negative rectal cancer located 4-12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of single port laparoscopic surgery between September 2013 and August 2014. The primary endpoint was TME quality; secondary endpoints included number of harvested lymph nodes and postoperative complications within 30 days (NCT01938027)...
October 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27744632/combined-robotic-transanal-total-mesorectal-excision-r-tatme-and-single-site-plus-one-port-r-sspo-technique-for-ultra-low-rectal-surgery-initial-experience-with-a-new-operation-approach
#19
Li-Jen Kuo, James Chi-Yong Ngu, Yiu-Shun Tong, Chia-Che Chen
OBJECTIVE: Robot-assisted rectal surgery is gaining popularity, and robotic single-site surgery is also being explored clinically. We report our initial experience with robotic transanal total mesorectal excision (R-taTME) and radical proctectomy using the robotic single-site plus one-port (R-SSPO) technique for low rectal surgery. METHODS: Between July 2015 and March 2016, 15 consecutive patients with ultra-low rectal lesions underwent R-taTME followed by radical proctectomy using the R-SSPO technique by a single surgeon...
October 15, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27735827/transanal-total-mesorectal-excision-international-registry-results-of-the-first-720-cases
#20
Marta Penna, Roel Hompes, Steve Arnold, Greg Wynn, Ralph Austin, Janindra Warusavitarne, Brendan Moran, George B Hanna, Neil J Mortensen, Paris P Tekkis
OBJECTIVE: This study aims to report short-term clinical and oncological outcomes from the international transanal Total Mesorectal Excision (taTME) registry for benign and malignant rectal pathology. BACKGROUND: TaTME is the latest minimally invasive transanal technique pioneered to facilitate difficult pelvic dissections. Outcomes have been published from small cohorts, but larger series can further assess the safety and efficacy of taTME in the wider surgical population...
October 4, 2016: Annals of Surgery
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