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https://www.readbyqxmd.com/read/28501248/local-excision-of-rectal-cancer
#1
REVIEW
Daniel Owen Young, Anjali S Kumar
Local excision (LE) of early-stage rectal cancer avoids the morbidity associated with radical surgery but has historically been associated with inferior oncologic outcomes. Newer techniques, including transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS), have been developed to improve the quality of LE and extend the benefits of LE to tumors in the more proximal rectum. This article provides an overview of conventional LE, TEM, and TAMIS techniques, including indications for their use and pertinent literature on their associated outcomes for rectal cancer...
June 2017: Surgical Clinics of North America
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
#2
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/28289660/transanal-endoscopic-microsurgery-for-patients-with-rectal-tumors-a-single-institution-s-experience
#3
Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E Samalavicius
PURPOSE: The purpose of this study was to look at our complication rates and recurrence rates, as well as the need for further radical surgery, in treating patients with benign and early malignant rectal tumors by using transanal endoscopic microsurgery (TEM). METHODS: Our study included 130 patients who had undergone TEM for rectal adenomas and early rectal cancer from December 2009 to December 2015 at the Department of Surgical Oncology, National Cancer Institute, Lithuania...
February 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28251355/long-term-results-of-transanal-endoscopic-microsurgery-after-endoscopic-polypectomy-of-malignant-rectal-adenoma
#4
T Junginger, U Goenner, M Hitzler, T T Trinh, A Heintz, M Blettner, D Wollschlaeger
BACKGROUND: There is no consensus on the treatment and prognosis of malignant rectal polyps. The aim of the present study was to determine the role of transanal endoscopic microsurgery (TEM) after endoscopic complete polypectomy of malignant rectal adenomas with long-term follow-up. METHODS: Of 105 patients with pT1 rectal carcinoma in 32 patients TEM followed complete endoscopic polypectomy while 73 had primary TEM. Local recurrence (LR), distant metastasis, overall and cancer-specific survival were determined by the Kaplan-Meier method...
March 1, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28152672/intraoperative-localization-of-rectal-tumors-using-liposomal-indocyanine-green
#5
Shlomo Magdassi, Shoshi Bar-David, Yael Friedman-Levi, Ehud Zigmond, Chen Varol, Guy Lahat, Joseph Klausner, Sara Eyal, Eran Nizri
BACKGROUND: Tumor localization may pose a significant challenge during minimally invasive rectal resection. Near-infrared (NIR) imaging can penetrate biological tissue and afford tumor localization from the external surface of the rectum. Our aim was to develop an NIR-based tool for rectal tumor imaging that can be administered intravenously. METHODS: We prepared indocyanine-green (ICG)-loaded liposomes by sonication. Liposomes were evaluated for their size and morphology...
February 1, 2017: Surgical Innovation
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
#6
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/27992283/transanal-endoscopic-microsurgery-combined-with-laparoscopic-colectomy-for-synchronous-colorectal-tumors-a-word-of-caution
#7
Nida Issa, Yaniv Fenig, Muhammad Khatib, Mustafa Yasin, Eldad Powsner, Wisam Khoury
BACKGROUND: The incidence of malignant synchronous colorectal tumors (SCRT) is between 2% and 5%, and the association of synchronous adenomatous polyps in colon cancer has been reported to be 15%-50%. Surgical resection is the primary treatment option for SCRT not amendable to endoscopic resection. Lesions in adjacent segments are usually treated with more extensive resection; however, there is still some controversy on how to best treat synchronous lesions in separate segments, especially when the rectum is involved...
December 19, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27888300/analysis-of-local-recurrences-after-transanal-endoscopic-microsurgery-for-low-risk-rectal-carcinoma
#8
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...
February 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27846173/current-controversies-in-transanal-surgery-for-rectal-cancer
#9
REVIEW
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/27668073/transanal-endoscopic-microsurgery-as-optimal-option-in-treatment-of-rare-rectal-lesions-a-single-centre-experience
#10
Monica Ortenzi, Roberto Ghiselli, Maria Michela Cappelletti Trombettoni, Luca Cardinali, Mario Guerrieri
AIM: To analyze the outcomes of transanal endoscopic microsurgery (TEM) in the treatment of rare rectal condition like mesenchymal tumors, condylomas, endometriosis and melanoma. METHODS: We retrospectively reviewed a twenty-three years database. Fifty-two patients were enrolled in this study. The lesions were considered suitable for TEM if they were within 20 cm from the anus. All of them underwent an accurate preoperative workup consisting in clinical examination, total colonoscopy with biopsies, endoscopic ultrasonography, and pelvic computerized tomography or pelvic magnetic resonance imaging...
September 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27547025/transanal-minimally-invasive-surgery-for-rectal-lesions
#11
Silvia Quaresima, Andrea Balla, Luana Franceschilli, Marco La Torre, Corrado Iafrate, Mostafa Shalaby, Nicola Di Lorenzo, Pierpaolo Sileri
BACKGROUND AND OBJECTIVES: Transanal minimally invasive surgery (TAMIS) has emerged as an alternative to transanal endoscopic microsurgery (TEM). The authors report their experience with TAMIS for the treatment of mid and high rectal tumors. METHODS: From November 2011 through May 2016, 31 patients (21 females, 68%), with a median age of 65 years who underwent single-port TAMIS were prospectively enrolled. Mean distance from the anal verge of the rectal tumors was 9...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27387173/the-surgical-defect-after-transanal-endoscopic-microsurgery-open-versus-closed-management
#12
Carl Brown, Manoj J Raval, P Terry Phang, Ahmer A Karimuddin
BACKGROUND: To determine whether closure of the defect created during full thickness excision of a rectal lesion with transanal endoscopic microsurgery (TEM) leads to fewer complications when compared to leaving the defect unsutured. METHODS: This is a single-center cohort study using a prospectively maintained database. All patients ≥18 years old treated with full thickness TEM with no compromise of the peritoneal cavity were included. Two cohorts were established: patients with the defect sutured and patients with the defect left open...
July 7, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27000716/transanal-endoscopic-microsurgery-for-large-benign-rectal-tumors-where-are-the-limits
#13
Reem Khoury, Simon D Duek, Nidal Issa, Wisam Khoury
INTRODUCTION: Local excision is the treatment of choice for large benign rectal lesions. Transanal endoscopic microsurgery is recommended. The excision of large lesions >4 cm has been previously described. We report our series of lesions >5 cm that have been excised via the transanal endoscopic microsurgery. METHODS: Patients who underwent transanal endoscopic microsurgery for rectal tumors, between the years 2002-2012, were identified. Patients with tumors greater than 5 cm consisted the study group...
May 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/26908311/laparoscopy-following-peritoneal-entry-during-transanal-endoscopic-microsurgery-may-increase-the-safety-and-maximize-the-benefits-of-the-transanal-excision
#14
N Issa, Y Fenig, M Yasin, H Schmilovitz-Weiss, W Khoury, E Powsner
BACKGROUND: Peritoneal entry (PE) during transanal endoscopic microsurgery (TEM) for tumors of the upper rectum is not an uncommon complication. The suture line of the rectal defect performed for PE is not devoid of leaks. Diagnostic laparoscopy after PE enables visualization and testing of the suture line. Here, we report the outcome of patients undergoing laparoscopy for PE following TEM. METHODS: Data pertaining to patients undergoing laparoscopy for PE following TEM between 2004 and 2013 were retrospectively collected...
April 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/26902614/transanal-endoscopic-microsurgery-for-rectal-cancer-t1-and-beyond-an-evidence-based-review
#15
Marco E Allaix, Alberto Arezzo, Mario Morino
BACKGROUND: The last three decades have witnessed significant improvements in the diagnosis, staging and treatment of rectal cancer leading to a more tailored approach. One of the most clinically relevant advances in this field is represented by transanal endoscopic microsurgery (TEM). Several studies have investigated its role in the treatment of rectal cancer. However, evidence-based recommendations are limited. The aim of this report is to provide an evidence-based review of current indications, controversies and future perspectives of TEM in the management of rectal cancer...
November 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/26882538/endoluminal-loco-regional-resection-by-tem-after-r1-endoscopic-removal-or-recurrence-of-rectal-tumors
#16
Silvia Quaresima, Andrea Balla, Giancarlo D'Ambrosio, Paolo Bruzzone, Pietro Ursi, Emanuele Lezoche, Alessandro M Paganini
PURPOSE: The aim of this study is to evaluate the safety and efficacy of endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) after R1 endoscopic resection or local recurrence of early rectal cancer after operative endoscopy. MATERIAL AND METHODS: Twenty patients with early rectal cancer were enrolled, including patients with incomplete endoscopic resection, or complete endoscopic resection of a tumor with unfavorable prognostic factors (group A, ten patients), and local recurrence after endoscopic removal (group B, ten patients)...
2016: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/26865896/removal-of-gallstone-from-mesorectum-after-laparoscopic-cholecystectomy-new-indication-for-transanal-endoscopic-microsurgery-technique
#17
Marek Szczepkowski, Alicja Przywózka, Tomasz Zieliński
Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for local excision of benign and malignant neoplasms in the rectum. Indications for this technique are constantly changing and extending. The aim of this study is to describe a case of a unique and innovative application of this surgical technique. A 72-year-old patient was admitted to the Clinical Department of General and Colorectal Surgery for elective resection of a tumor located in the perianal area using the TEM surgical technique...
January 2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/26861635/postoperative-complications-in-the-treatment-of-rectal-neoplasia-by-transanal-endoscopic-microsurgery-a-prospective-study-of-risk-factors-and-time-course
#18
Carlos Frederico S Marques, Caio Sergio R Nahas, Ulysses Ribeiro, Leonardo A Bustamante, Rodrigo Ambar Pinto, Eduardo Kenzo Mory, Ivan Cecconello, Sergio Carlos Nahas
PURPOSE: Transanal endoscopic microsurgery (TEM) is a safe and efficient minimally invasive treatment for rectal benign and early malignant neoplasia, but postoperative complications may be severe. We aimed to evaluate the risk factors related to the incidence, severity, and time course of postoperative complications of TEM. METHODS: This is a prospective study of postoperative complications in 53 patients (>18 years old) with benign or early rectal neoplasia who underwent TEM with curative intention or, for higher stages, palliation...
April 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/26794664/the-accuracy-of-endorectal-ultrasound-in-staging-rectal-lesions-in-patients-undergoing-transanal-endoscopic-microsurgery
#19
Marisa Leon-Carlyle, Jacqueline A Brown, Jeremy Hamm, P Terry Phang, Manoj J Raval, Carl J Brown
BACKGROUND: Endorectal ultrasound (ERUS) is used to preoperatively assess locoregional stage in patients with rectal neoplasms. This study evaluates the accuracy of ERUS in determining the T stage of rectal neoplasms treated by transanal endoscopic microsurgery (TEM). METHODS: All patients in the St Paul's Hospital TEM database were evaluated and excluded if they had been treated with neoadjuvant therapy. ERUS results were compared with gold-standard postoperative histopathology reports...
September 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/20455665/gastrointestinal-stromal-tumor-an-ultrastructural-investigation-on-regional-differences-with-considerations-on-their-histogenesis
#20
Kyung-Whan Min
Gastrointestinal stromal tumor (GIST) is the most frequent spindle cell tumor in the gastrointestinal tract and may arise from esophagus to rectum. The stomach is the most frequent site, followed by small intestine, rectum, and esophagus. There have been some regional differences reported in their histopathologic and clinical presentations. The purpose of this study is to compare ultrastructural features of GIST, according to its anatomic site, in order to provide additional data to support the current concept of its histogenesis...
May 2010: Ultrastructural Pathology
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