scholarly journals Novel use of the Heald anal stent after transanal endoscopic microsurgery

2011 ◽  
Vol 1 (1) ◽  
pp. 15
Author(s):  
Alun E. Jones ◽  
Guy F. Nash
Keyword(s):  
Transanal Endoscopic Microsurgery ◽  
Rectal Neoplasms ◽  
Rectal Wall ◽  
Pelvic Sepsis ◽  
Defect Closure ◽  
Continuous Suture ◽  
Popular Method ◽  
Minimal Morbidity ◽  
Secondary Intention ◽  
Endoscopic Microsurgery

Distension of the rectum following transanal endoscopic microsurgery (TEMS) increases rectal intra-luminal pressure and may promote pelvic sepsis by contaminating the rectal defect. We describe the first use of a Heald anal stent to decompress the rectum following TEMS. Transanal endoscopic microsurgery (TEMS) is an increasingly popular method of resecting rectal neoplasms with minimal morbidity and mortality. Following excision of the lesion, the defect in the rectal wall is usually repaired by a continuous suture. However there is no evidence to suggest defect closure is superior to leaving this to heal by secondary intention. Distension of the rectum post-operatively increases rectal intra-luminal pressure and may promote pelvic sepsis by contaminating the rectal defect.

Transanal Endoscopic Microsurgery for Rectal Neoplasms. How I Do It

2012 ◽  
Vol 17 (3) ◽  
pp. 586-592 ◽  
Author(s):  
Marco E. Allaix ◽  
Alberto Arezzo ◽  
Simone Arolfo ◽  
Mario Caldart ◽  
Fabrizio Rebecchi ◽  
...  
Keyword(s):  
Transanal Endoscopic Microsurgery ◽  
Rectal Neoplasms ◽  
Endoscopic Microsurgery

scholarly journals Transanal Endoscopic Microsurgery (TEM) for Rectal Neoplasms

2012 ◽  
Vol 03 (06) ◽  
pp. 283-289
Author(s):  
Manuel Ferrer-Márquez ◽  
Ángel Reina-Duarte ◽  
Francisco Rubio-Gil ◽  
Ricardo Belda-Lozano ◽  
Antonio Álvarez-García
Keyword(s):  
Transanal Endoscopic Microsurgery ◽  
Rectal Neoplasms ◽  
Endoscopic Microsurgery

Transanal endoscopic microsurgery: results of the first 50 cases

2012 ◽  
Vol 19 (1) ◽  
pp. 45-49
Author(s):  
Narimantas Evaldas SAMALAVIČIUS ◽  
Alfredas KILIUS ◽  
Kęstutis PETRULIS ◽  
Simona LETAUTIENĖ ◽  
Rūta GRIGIENĖ ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Transanal Endoscopic Microsurgery ◽  
Rectal Wall ◽  
Anal Verge ◽  
Abdominal Cavity ◽  
Safety Margin ◽  
Adjuvant Chemoradiotherapy ◽  
Rectal Stricture ◽  
Early Rectal Cancer ◽  
Endoscopic Microsurgery

The aim of the study was to share the experience and first results of implementation of transanal endoscopic microsurgery (TEM) technique for the removal of rectal adenomas, early rectal cancer or rectal stricture in the Center of Oncosurgery, Oncology Institute of Vilnius University. Materials and methods. From October 2009 to October 2011, a total of 50 patients underwent TEM for rectal adenomas, early rectal cancer or rectal stricture. The patients were 25 women and 25 men, 31 to 87 years of age (average 65 years). Rectal lesions were from 0.9 to 7.0 cm in diameter, 3–13 cm from the anal verge. Full thickness excision with 1 cm safety margin was achieved in all cases except two (mucosal excision), followed by closing of the rectal wall defect in one-layer running monocryl 3.0 suture using silver clips. In one case (TEM was performed for T2 rectal cancer), abdominal cavity was penetrated and two-layer closure was preferred. Results. In these series of 50 patients there was 1 (2%) complication (cystitis). No postoperative exitus occurred. The hospitalisation period ranged from 2 to 13 days (average 6 days). Final histology revealed 30 (60%) tubular or villous adenomas, 6 (12%) carcinomas in situ (pTis), 7 (14%) T1, 4 (8%) T2 cancers, and well-differentiated neuroendocrine tumors in 3 (6%) were diagnosed. One patient underwent open partial TME in pT1 group; the tumor was in the upper third of rectum and preoperatively evaluated as pTis disease. In two cases (pT1 group) lymphovascular invasion was present on final pathology, so they were offered a postoperative adjuvant chemoradiotherapy. Other 4 patients in T1 group are under surveillance. All 4 patients with T2 lesions were offered adjuvant chemoradiotherapy, one patient refused further treatment. Conclusions. TEM is an alternative for transanal excision of rectal adenomas and early rectal cancer. Further follow-up is necessary to evaluate the recurrence rate of cancer in invasive cancer patients group.

scholarly journals Transanal endoscopic microsurgery (TEM): a minimally invasive procedure for treatment of selected rectal neoplasms

2010 ◽  
Vol 23 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Sergio C. Nahas ◽  
Caio S. R. Nahas ◽  
Carlos Frederico S. Marques ◽  
Andre Roncon Dias ◽  
Wilson M. Pollara ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Low Anterior Resection ◽  
Transanal Endoscopic Microsurgery ◽  
Rectal Neoplasms ◽  
Radical Surgery ◽  
Invasive Procedure ◽  
Minimally Invasive Procedure ◽  
Rectal Tumors ◽  
Review Of The Literature ◽  
Endoscopic Microsurgery

Transanal endoscopic microsurgery (TEM) provides a minimally invasive alternative to radical surgery for excision of benign and malignant rectal tumors. TEM aims to provide an alternative to conventional abdominal surgery (low anterior resection or abdominoperineal amputations), which carries not inconsiderable morbidity and mortality. Based on review of the literature and in the authors experience, this review present the method and indications for TEM.

scholarly journals TEM technique in the treatment of patients with early rectal cancer

2020 ◽  
Vol 179 (2) ◽  
pp. 55-58
Author(s):  
P. N. Romaschenko ◽  
A. A. Sazonov ◽  
N. A. Maistrenko ◽  
D. A. Ilyasbekov
Keyword(s):  
Rectal Cancer ◽  
Surgical Treatment ◽  
Transanal Endoscopic Microsurgery ◽  
Clinical Case ◽  
Rectal Neoplasms ◽  
Surgical Trauma ◽  
Early Rectal Cancer ◽  
Positive Potential ◽  
Important Direction ◽  
Endoscopic Microsurgery

The use of organ-preserving interventions remains the most important direction in improving of surgical treatment of patients with rectal cancer. One of the promising options for its implementation is the TEM (transanal endoscopic microsurgery) technique, which allows local removal of rectal neoplasms by its full-wall resection. However, indications for this intervention are still a matter of debate. The presented clinical case demonstrates the positive potential of the TEM technique, which consists of reducing surgical trauma without violating the basic oncological principles.

Transanal Endoscopic Microsurgery Versus Standard Transanal Excision for the Removal of Rectal Neoplasms

2015 ◽  
Vol 58 (2) ◽  
pp. 254-261 ◽  
Author(s):  
Cillian Clancy ◽  
John P. Burke ◽  
Mathew R. Albert ◽  
P. Ronan O’Connell ◽  
Desmond C. Winter
Keyword(s):  
Transanal Endoscopic Microsurgery ◽  
Rectal Neoplasms ◽  
Transanal Excision ◽  
Endoscopic Microsurgery

scholarly journals Transanal endoscopic microsurgery in the treatment of patients with benign neoplasms and early rectal cancer

2022 ◽  
Vol 20 (6) ◽  
pp. 13-22
Author(s):  
V. A. Avdeenko ◽  
A. A. Nevolskikh ◽  
A. R. Brodsky ◽  
R. F. Zibirov ◽  
I. A. Orekhov ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Postoperative Complications ◽  
Tumor Invasion ◽  
Transanal Endoscopic Microsurgery ◽  
Rectal Neoplasms ◽  
Tumor Response ◽  
Chemoradiation Therapy ◽  
Early Rectal Cancer ◽  
Duration Of Surgery ◽  
Endoscopic Microsurgery

Introduction. Transanal endoscopic microsurgery (tem) is a method that allows the specialists to clearly visualize a tumor and bimanually remove the tumor using a set of special instruments. For a number of patients with a good tumor response to chemoradiation therapy (crt), tem is used as an advanced biopsy technique for tumor verification. The purpose of the study was to analyze the results of tem performed at a. Tsyb mrrc. Material and methods. Between 2015 and 2020, 64 patients (men – 42.2 % and women – 57.8 %) underwent tem. Forty patients had rectal cancer and 25 patients had benign rectal tumors. The indication for tem in patients with rectal cancer was the evidence of tis-t1 tumor by postoperative examination findings (mri and endosonography). Eleven patients with stage ii–iii rectal cancer received chemoradiation therapy. The indication for performing tem after rt in patients with rectal cancer was a good tumor response (mri trg1- 2). For statistical processing, commercial biomedical packages prism 3.1 and instat (graphpad software, inc., san diego, usa) were used. The significance of the differences between the indicators was assessed using the pearson χ2 test. Differences were considered significant if the p value was less than 0.05. Results. The median duration of surgery was 110 minutes (30–385). The volume of blood loss did not exceed 40 ml. Postoperative complications were observed in 15 cases (23.4 %). Grade 3 complications according to the clavien-dindo classification were observed in 5 (7.8 %) cases. Postoperative complications occurred more frequently in patients after crt (10.7 and 18.2 %; p=0.603), however, the differences were not statistically significant. At a median follow-up of 18 months (7–30), local relapses developed in 6 out of 26 (23 %) patients who underwent surgery alone. There were no signs of local recurrence in patients with adenocarcinomas after neoadjuvant chemotherapy and rectal adenomas. When comparing patients with the depth of tumor invasion tis-t1sm2 and t1sm3-t2, local relapses occurred in 1 of 21 (4.7 %) and 5 of 12 (41.6 %) cases, respectively (p=0.015). Conclusion. The analysis of the results of tem interventions in patients with rectal neoplasms allows us to conclude that this method of treatment is a priority for patients with benign rectal neoplasms and early rectal cancer. The method can also be used after rt or crt in patients with tumor invasion ≥t1sm3, provided a complete or almost complete tumor response to the treatment.

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