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Transanal endoscopic operation

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
Gerardo Cortese, Gabriele Sales, Giorgia Maiolo, Mario Morino, Martina Scanu, Luca Brazzi
BACKGROUND: The feasibility and safety of transanal endoscopic microsurgery (TEM) performed under spinal anaesthesia (SA) has been recently demonstrated. This retrospective study compared the differences in opioid consumption and postoperative recovery in patients undergoing TEM under GA and SA. METHODS: All consecutive patients who underwent TEM at 'Città della Salute e della Scienza' hospital of Turin (Italy) between January 2012 and December 2015 were enrolled...
March 7, 2018: Minerva Anestesiologica
Matas Jakubauskas, Valdemaras Jotautas, Eligijus Poskus, Saulius Mikalauskas, Gintare Valeikaite-Tauginiene, Kestutis Strupas, Tomas Poskus
PURPOSE: Transanal endoscopic microsurgery (TEM) procedure could potentially influence the development of fecal incontinence later in life. The aim of our study was to assess long-term functional outcomes after TEM and to determine possible variables related to incontinence. METHODS: Patients, enrolled in a prospectively collected TEM operation database, were interviewed using a postal questionnaire. The questionnaire consisted of EuroQol (EQ)-5D-5L quality of life questionnaire, Wexner fecal incontinence grading scale, and additional questions about other perianal operations and obstetric history for women...
February 22, 2018: International Journal of Colorectal Disease
Gang Xu, Peipei Wang, Yao Xiao, Xin Wu, Guole Lin
RATIONALE: Rectal neuroendocrine tumor (NET) is a relatively rare tumor. Well-differentiated NETs (G1 and G2) rarely display distant metastasis at initial diagnosis. Currently, treatment for the primary lesions of rectal NETs with liver metastasis remains controversial. The liver metastasis was resected in local hospital. Transanal endoscopic microsurgery (TEM) has emerged as an effective minimally invasive surgery for local resection of lower rectal lesions. Herein, we reported the initial application of TEM to remove the rectal primary lesion in patients with low rectal NETs (G2) with giant liver metastases...
December 2017: Medicine (Baltimore)
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
Seung Yoon Yang, Byung Soh Min, Woo Ram Kim
A granular cell tumor (GCT) is an uncommon mesenchymal lesion that rarely occurs in the colon and the rectum. We describe the case of 51-year-old man with a 2-cm-sized rectal GCT 10 cm above the anal verge that was incidentally detected after a screening colonoscopy. Preoperative radiologic studies demonstrated a suspicious submucosal rectal mass with mesorectal fat infiltration, but without circumferential resection margin threatening, extramural vessel invasion, and regional lymph-node enlargement. The tumor was resected by using a transanal endoscopic operation (TEO) without immediate postoperative complications...
December 2017: Annals of Coloproctology
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
Giovanni Dapri, Anny Cadenas Fabres, Olivier Nicod, Garces Duran Rodrigo, Vinciane Muls, Marc Van Gossum
Endoscopic mucosal resection and endoscopic submucosal dissection (ESD) are operative endoscopies that have been performed since a long time. Recently, an evolution of laparoscopy called transanal minimally invasive surgery began to be popularized, and it can be adopted in the face of difficult cases for endoscopic mucosal resection/ESD. In this video, a 36-year-old woman was submitted to transanal minimally invasive surgery resection, after unsuccessful ESD, for a 2-cm polyp located anteriorly in the anal canal, just beyond the pectineal line...
January 12, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
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
Xin Wu, Guole Lin, Huizhong Qiu, Jiaolin Zhou
BACKGROUND: Transanal endoscopic microsurgery (TEM) has been accepted worldwide for the treatment of local rectal lesions. Rare rectal tumors consist of several different types of malignant or benign tumors. Surgical management is considered to be the only curative option. The aim of this study is to investigate the role of TEM in the treatment of rare rectal tumors. MATERIALS AND METHODS: A total of 147 patients with rare rectal tumors underwent TEM in our center from April 2006 to May 2017...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Rina Takahashi, Kazuhiro Sakamoto, Hisashi Ro, Kazumasa Kure, Masaya Kawai, Shun Ishiyama, Kiichi Sugimoto, Yutaka Kojima, Atsushi Okuzawa, Yuichi Tomiki
A 76-year-old male underwent endoscopic mucosal resection for a stage T1 tumour of the sigmoid colon. We performed laparoscopic sigmoidectomy through 5 ports using needlescopic instruments. The resected specimen was extracted from the abdominal cavity transanally. After attaching an anvil to the sigmoidal stump, the rectal stump was reclosed using an endoscopic linear stapler, and then, colorectal anastomosis was conducted using the double stapling technique. Performing transanal specimen extraction using needlescopic forceps improves aesthetic outcomes and reduces post-operative pain and the risk of abdominal incisional hernias...
October 23, 2017: Journal of Minimal Access Surgery
Yaniv Fenig, Mansour Khoury, Hemda Schmilovitz-Weiss, Rachel Gingold-Belfer, Gil Nissim Bachar, Nidal Issa
BACKGROUND: The prevalence of obesity is as high as one-third of the adult population in the ultrasound. Obese patients operated for rectal cancer are less likely to undergo sphincter-preserving surgery, and have an increased morbidity and mortality. We aim to report the outcomes of transanal-endoscopic-microsurgery (TEM) in obese patients with benign and malignant neoplasms. MATERIALS AND METHODS: An analysis was carried out of all patients undergoing TEM at a single institution between 2004 and 2015...
January 2018: European Journal of Gastroenterology & Hepatology
Hayim Gilshtein, Mariya Neymark, Elias Manassa, Wisam Khoury, Daniel Duek
BACKGROUND: Distal rectal cancer resection is an ongoing challenge for the colorectal surgeon. In recent years new technical approaches, especially with implementation of transanal platforms were developed to help in the visualization and resection of these tumors. Nevertheless, the use of these platforms is demanding with significant complications during the onset phase. METHODS: Patients with very low rectal cancer were operated on in a single tertiary center with a combined abdominal and transanal endoscopic microsurgery (TEM) approach...
October 24, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
M Ortenzi, R Ghiselli, A Paolucci, M Guerrieri
BACKGROUND: The success of transanal endoscopic microsurgery (TEM) for early rectal cancer depends on proper indications and strict patient selection. When unfavorable pathologic features are identified after TEM operation, total mesorectal excision is recommended to minimize the risk of recurrence. In this study, data were collected in a retrospective series of patients to determine the results of laparoscopic reoperation after TEM. METHODS: All patients underwent an accurate rectal-digital examination and clinical tumor staging by transanal endosonography, CT, and/or MRI...
October 19, 2017: Surgical Endoscopy
Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E Samalavicius
PURPOSE: The purpose of this study is to look at our early postoperative results, recurrence rates and need for further radical surgery in treating large (> 5 cm) rectal tumours by transanal endoscopic microsurgery (TEM). METHODS: Patients who underwent TEM for rectal tumours greater than 5 cm were included. Tumour diameter was determined based on fresh specimen measurements. We recorded the demographics, operative details, final pathology, length of hospital stay, complications and recurrence rates...
December 2017: International Journal of Colorectal Disease
Qianqian Shao, Guole Lin, Huizhong Qiu
OBJECTIVE: To assess the efficacy of full-thickness excision using transanal endoscopic microsurgery (TEM) in the treatment of rectal neuroendocrine tumors (NET). METHODS: Clinicopathological and follow-up data of 90 rectal NET patients who underwent TEM between December 2006 and December 2016 at our department were retrospectively analyzed. TEM was performed as primary excision in 66 patients and as the second complete surgery because of suspected positive margin of samples after colonoscopic polypectomy in 24 patients...
September 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Osama Eldamshety, Islam H Metwally, Elsayed Ghoneem, Wagdi F Elkashef
Rectal gastrointestinal stromal tumours (GISTs) are uncommon tumours and usually present with large sizes. We present two cases of rectal GIST. Imatinib was used in the setting of neoadjuvant and adjuvant therapy. Both tumours were resected transanally by the transanal endoscopic operation (TEO) platform. Oncosurgeons are recommended to implement sphincter-sparing surgeries for these cases.
2017: Ecancermedicalscience
Liu He, Yi Xiao
Transanal total mesorectal excision (taTME) is a novel operative approach of the radical surgery for rectal cancer, and has been a hot topic in colorectal surgery for years. TaTME aims to solve some problems from previous TME, such as exposure of peripheral mid-lower rectal space, judge of distal cutting margin, and to carry out completely minimal invasive operation. According to the degree of completion of different surgical approach, taTME can be divided into laparoscopic assisted taTME (hybrid taTME) and fully through the anal approach to complete the taTME (pure taTME)...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Guole Lin
Transanal endoscopic microsurgery (TEM) is currently the only one-port system in endoscopic surgery, which a direct endoluminal approach can lead to the target organ through a natural opening of human body. TEM has been applied in colorectal surgery for over 3 decades. Compared with radical surgery, TEM has the advantages, such as quicker recovery, shorter hospital stay and fewer complications. One perfect TEM surgical system, which mainly consists of three parts, namely peculiar rectoscope for surgery, special surgical instruments and imaging system, is the foundation of standardized development of TEM...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Lawrence Lee, Justin Kelly, George J Nassif, Deborah Keller, Teresa C Debeche-Adams, Paul A Mancuso, John R Monson, Matthew R Albert, Sam B Atallah
INTRODUCTION: Transanal minimally invasive surgery (TAMIS) is an endoscopic operating platform for local excision of rectal neoplasms. However, it may be technically demanding, and its learning curve has yet to be adequately defined. The objective of this study was to determine the number of TAMIS procedures for the local excision of rectal neoplasm required to reach proficiency. METHODS AND PROCEDURES: All TAMIS cases performed from 07/2009 to 12/2016 at a single high-volume tertiary care institution for local excision of benign and malignant rectal neoplasia were identified from a prospective database...
August 15, 2017: Surgical Endoscopy
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