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Trans-anal endoscopic microsurgery for non- adenomatous rectal lesions

World Journal of Gastrointestinal Surgery 2023年第11期15卷 2406-2412页

作者： dafna shilo yaacobi Eliahu Y Bekhor Muhammad Khalifa Tal E Sandler Nidal Issa Department of Plastic Surgery and Burns Rabin Medical CenterPetah Tikva 4941492Israel Department of Surgery Rabin Medical CenterPetah Tikva 4941492Israel Department of Anesthesiology Rabin Medical CenterPetah Tikva 4941492Israel

BACKGROUND Trans-anal endoscopic microsurgery(TEM)enables a good visualization of the surgical field and is considered the method of choice for excision of adenomas and early T1 rectal *** rectum and retro-rectal space might be the origin of uncommon neoplasms,benign and aggressive,certain require radical trans-abdominal surgery,while others can be treated by a less aggressive *** this study we report outcomes in patients undergoing TEM for rare and non-adenomatous rectal and retro-rectal lesions over a period of 11 *** Between January 2008 to December 2019 a retrospective analysis was completed for all patients who underwent TEM for non-adenomatous rectal lesion or retro-rectal mass in our *** were discharged once diet was well tolerated and no complications were *** were evaluated at 3 wk post operatively,then at 3-mo intervals for the first 2 years and every 6 mo depending on the nature of the final *** examination and rectoscopy were performed during each of the follow-up *** Out of 198 patients who underwent TEM during the study period,18 had non-adenomatous rectal or retro-rectal *** age was 47 *** mean size of the lesions was 2.9 mm,with a mean distance from the anal margin of 7.9 *** surgical time was 97.8 *** were no intra-operative neither late post-operative *** length of stay was 2.5 *** patient follow-up duration was 42 *** TEM allows for reduced morbidity given its minimally invasive *** should be familiar with the technique but careful patient selection should be *** can be used safely for uncommon rectal and selected retro-rectal lesions without compromising *** believe that it should be reasonably considered as one of the surgical methods when treating rare lesions.

关键词： Trans-anal endoscopic microsurgery Rectal lesions MicrosurgeryTrans-anal endoscopic microsurgery Rectal lesions Microsurgery

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Excision of malignant and pre-malignant rectal lesions by transanal endoscopic microsurgery in patients under 50 years of age

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World Journal of Gastrointestinal Surgery 2023年第9期15卷 1892-1900页

作者： dafna shilo yaacobi Yael Berger Tali Shaltiel Eliahu Y Bekhor Muhammad Khalifa Nidal Issa Department of Plastic Surgery&Burns Rabin Medical CenterPetah Tikva 4941492Israel Department of Surgery Rabin Medical Center-Hasharon HospitalPetah Tikva 4941492Israel

BACKGROUND The most common technique for treating benign and early malignant rectal lesions is transanal endoscopic microsurgery(TEM).Local excision is an acceptable technique for high-risk and elderly patients,but there are hardly any data regarding young *** To describe TEM outcomes in patients under 50 years of *** We collected demographic,clinical,and pathological data from all patients under the age of 50 years who underwent the TEM procedure at Hasharon Rabin Medical Center from January 2005 to December *** During the study period,a total of 26 patients under the age of 50 years underwent TEM *** mean age was 43.3 ***(42.0%)were *** mean operative time was 67 min,and the mean tumor size was 2.39 cm,with a mean anal verge distance of 8.50 *** major intraoperative or postoperative complications were *** median length of stay was 2 ***(26.9%)lesions were adenomas with low-grade dysplasia,four(15.4%)were high-grade dysplasia adenomas,two were T1 carcinomas(7.8%),and three were T2 carcinomas(11.5%).No residual disease was found following endoscopic polypectomy in two patients(7.8%),but four(15.4%)had other *** margins were negative in all *** recurrence was detected in one patient 33 mo following *** Among young adult patients,TEM for benign rectal lesions has excellent *** may also offer a balance between the efficacy of complete oncologic resection and postoperative quality of life in the treatment of rectal *** some cases,it may be considered an alternative to radical surgery.

关键词： Transanal endoscopic microsurgery Young adults Rectal lesions Benign lesions Malignant lesions Radical surgery alternative

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