检索结果-南通市图书馆

transanal endoscopic microsurgery: The first attempt in treatment of rectal amyloidoma

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第4期21卷 1324-1328页

作者： Richa Sharma Virgilio V George Department of General Surgery School of MedicineIndiana UniversityIndianapolisIN 46202United States

Localized amyloidosis is characterized by amyloid protein deposition restricted to one organ or tissue without systemic involvement. Gastrointestinal manifestations of localized amyloidoma are unusual, which makes amyloidoma restricted to the rectum a very rare diagnosis requiring a high index of suspicion. We present a rare account for rectal amyloidoma with an unusual presentation of obstructive symptoms and its treatment using a sophisticated surgical modality, transanal endoscopic microsurgery(TEM), which resulted in complete excision of the lesion without hospitalization and complications. The successful treatment for thisrectal amyloidoma using TEM emphasizes the need to broaden its application in the treatment of various rectal lesions while preserving organ function and decreasing recurrence.

关键词： transanal endoscopic microsurgery Amyloidoma Local

Clinical efficacy and pathological outcomes of transanal endoscopic intersphincteric resection for low rectal cancer

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Oncology 2024年第3期16卷 933-944页

作者： Zhi-Wen Xu Jing-Tao Zhu Hao-Yu Bai Xue-Jun Yu Qing-Qi Hong Jun You Department of Gastrointestinal Oncology Surgery The First Affiliated Hospital of Xiamen UniversitySchool of MedicineXiamen UniversityXiamen 361000Fujian ProvinceChina

BACKGROUND transanal endoscopic intersphincteric resection(ISR)surgery currently lacks sufficient clinical research and *** To investigate the clinical effectiveness of transanal endoscopic ISR,in order to promote the clinical application and development of this *** This study utilized a retrospective case series *** and pathological data of patients with lower rectal cancer who underwent transanal endoscopic ISR at the First Affiliated Hospital of Xiamen University between May 2018 and May 2023 were *** patients underwent transanal endoscopic ISR as the surgical *** conducted this study to determine the perioperative recovery status,postoperative complications,and pathological specimen charac-teristics of this group of *** This study included 45 eligible patients,with no perioperative *** overall incidence of early complications was 22.22%,with a rate of 4.44%for Clavien-Dindo grade≥III *** patients(4.4%)developed anastomotic leakage after surgery,including one case of grade A and one case of grade *** pathological examination confirmed negative circumferential resection margins and distal resection margins in all *** mean distance between the tumor lower margin and distal resection margin was found to be 2.30±0.62 *** transanal endoscopic ISR procedure consistently yielded high quality pathological *** transanal endoscopic ISR is safe,feasible,and provides a clear anatomical *** is associated with a low incidence of postoperative complications and favorable pathological outcomes,making it worth further research and application.

关键词： Intersphincteric resection transanal Rectal cancer Complications Endoscopic

Local excision by transanal endoscopic surgery

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第31期21卷 9286-9296页

作者： Luis J García-Flórez Jorge L Otero-Díez General and Digestive Surgery Service Colorectal UnitHospital San Agustín

transanal endoscopic surgery(TES) consists of a series of anorectal surgical procedures using different devices that are introduced into the anal canal. TES has been developed significantly since it was first used in the 1980 s. The key point for the success of these techniques is how accurately patients are selected. The main indication was the resection of endoscopically unresectable adenomas. In recent years,these techniques have become more widespread which has allowed them to be applied in conservative rectal procedures for both benign diseases and selected cases of rectal cancer. For more advanced rectal cancers it should be considered palliative or,in some controlled trials,experimental. The role of newer endoscopic techniques available has not yet been defined. TES may allow for new strategies in the treatment of rectal pathology,like transanal natural orifice transluminal endoscopic surgery or total mesorectal excision.

关键词： transanal endoscopic surgery Rectal adenoma Early

transanal total mesorectal excision: Myths and reality

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Oncology 2016年第5期7卷 337-339页

作者： Nicolas C Buchs Marta Penna Alexander L Bloemendaal Roel Hompes Division of Visceral Surgery Department of Surgery University Hospitals of Geneva Department of Colorectal Surgery Churchill Hospital Oxford University Hospitals

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. Beyond these technical considerations, the next challenge seems to be clearly the safe introduction of this approach, motivating the development of dedicated courses.

关键词： transanal total mesorectal excision Bottom up TAMIS Laparoscopy Robotic Outcomes Rectal cancer

Full-thickness excision using transanal endoscopic microsurgery for treatment of rectal neuroendocrine tumors

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第30期21卷 9142-9149页

作者： Wei-Jie Chen Nan Wu Jiao-Lin Zhou Guo-Le Lin Hui-Zhong Qiu Department of Surgery Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical Sciences

AIM:To assess the efficacy of full-thickness excision using transanal endoscopic microsurgery(TEM) in the treatment of rectal neuroendocrine ***:We analyzed the data of all rectal neuroendocrine tumor patients who underwent local full-thickness excision using TEM between December 2006 and December 2014 at our department. Data collected included patient demographics,tumor characteristics,operative details,postoperative outcomes,pathologic findings,and follow-ups. RESULTS:Full-thickness excision using TEM was performed as a primary excision(n = 38) or as complete surgery after incomplete resection by endoscopic polypectomy(n = 21). The mean size of a primary tumor was 0.96 ± 0.21 cm,and the mean distance of the tumor from the anal verge was 8.4 ± 1.4 cm. The mean duration of the operation was 57.6 ± 13.7 min,and the mean blood loss was 13.5 ± 6.6 m L. No minor morbidities,transient fecal incontinence,or wound dehiscence was found. Histopathologically,all tumors showed typical histology without lymphatic or vessel infiltration,and both deep and lateral surgical margins were completely free of tumors. Among 21 cases of complete surgery after endoscopic polypectomy,9 were histologically shown to have a residual tumor in the specimens obtained by TEM. No additional radical surgery was performed. Norecurrence was noted during the median of 3 years' ***:Full-thickness excision using TEM could be a first surgical option for complete removal of upper small rectal neuroendocrine tumors.

关键词： transanal endoscopic microsurgery Rectalneuroendocrine tumor Full-thickness excision Primaryexcision Complete excision Retrospective study

Sphincter lesions observed on ultrasound after transanal endoscopic surgery

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第46期21卷 13160-13165页

作者： Laura Mora López Xavier Serra-Aracil Salvador Navarro Soto General and Digestive Surgery Service Parc Tauli University HospitalUniversidad Autonoma Barcelona

AIM: To assess the morphological impact of transanal endoscopic surgery on the sphincter apparatus using the modified Starck classification. METHODS: A prospective,observational study of 118 consecutive patients undergoing transanal Endoscopic Operation/transanal Endoscopic Microsurgery(TEO/TEM) from March 2013 to May 2014 was performed. All the patients underwent an endoanal ultrasound prior to surgery and one and four months postoperatively in order to measure sphincter width,identify sphincter defects and to quantify them in terms of the level,depth and size of the affected anal canal. To assess the lesions,we used the "modified" Starck classifi-cation,which incorporates the variable "sphincter fragmentation". The results were correlated with the Wexner incontinence ***: Of the 118 patients,twelve(sphincter lesions) were excluded. The results of the 106 patients were as follows after one month: 31(29.2%) lesions found on ultrasound after one month,median overall Starck score of 4(range 3-6); 10(9.4%) defects in the internal anal sphincter(IAS) and 3(2.8%) in the external anal sphincter(EAS); 17 patients(16%) had fragmentation of the sphincter apparatus with both sphincters affected in one case. At four months: 7(6.6%) defects,all in the IAS,overall median Starck score of 4(range 3-6). Mean IAS widths were 3.5 mm(SD 1.14) preoperatively,4.38 mm(SD 2.1) one month postoperatively and 4.03 mm(SD 1.46) four months postoperatively. The only statistically significant difference in sphincter width in the IAS measurements was between preoperatively and one month postoperatively. No incontinence was reported,even in cases of ultrasound ***: TEO/TEM may produce ultrasounda b n o r m a l i t i e s b u t t h i s i s n o t a c c o m p a n i e d b y clinical changes in continence. The modified Starck classification is useful for describing and managing these disorders.

关键词： transanal endoscopic surgery Endoscopic ultrasound

Midterm outcome of stapled transanal rectal resection for obstructed defecation syndrome:A single-institution experience in China

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2013年第38期19卷 6472-6478页

作者： Bin Zhang Jian-Hua Ding Yu-Juan Zhao Meng Zhang Shu-Hui Yin Ying-Ying Feng Ke Zhao Department of Colorectal Surgery the Second Artillery General Hospital Department of Laboratory Medicine the Second Artillery General Hospital

AIM:To assess midterm results of stapled transanal rectal resection(STARR)for obstructed defecation syndrome(ODS)and predictive factors for ***:From May 2007 to May 2009,75 female patients underwent STARR and were included in the present *** and postoperative workup consisted of standardized interview and physical examination including proctoscopy,colonoscopy,anorectal manometry,and *** and functional results were assessed by standardized questionnaires for the assessment of constipation constipation scoring system(CSS),Longo’s ODS score,and symptom severity score(SSS),incontinence Wexner incontinence score(WS),quality of life Patient Assessment of Constipation-Quality of Life Questionnaire(PAC-QOL),and patient satisfaction visual analog scale(VAS).Data were collected prospectively at baseline,12 and 30 ***:The median follow-up was 30 mo(range,30-46 mo).Late postoperative complications occurred in 11(14.7%)*** of these patients required procedure-related reintervention(one diverticulectomy and two excision of staple granuloma).Although the recurrence rate was 10.7%,constipation scores(CSS,ODS score and SSS)significantly improved after STARR(P<0.0001).Significant reduction in ODS symptoms was matched by an improvement in the PAC-QOL and VAS(P<0.0001),and the satisfaction index was excellent in 25(33.3%)patients,good in 23(30.7%),fairly good in 14(18.7%),and poor in 13(17.3%).Nevertheless,the WS increased after STARR(P=0.0169).Incontinence was present or deteriorated in 8(10.7%)patients;6(8%)of whom were new *** analysis revealed that the occurrence of fecal incontinence(preoperative,postoperative or new-onset incontinence;P=0.028,0.000,and 0.007,respectively)was associated with the success of the ***:STARR is an acceptable procedure for the surgical correction of ***,its impact on symptomatic recurrence and postoperative incontinence may be problematic.

关键词： Colorectal surgery Constipation Stapled transanal rectal resection

Novel technique for anastomotic salvage using transanal minimally invasive surgery:A case report

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Surgery 2019年第5期11卷 271-278页

作者： Oscar A Olavarria Robert L Kress Shinil K Shah Amit K Agarwal Center for Surgical Trials and Evidence-Based Practice McGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTX 77033United States Department of Surgery McGovern Medical School at the University of Texas Health Science Center HoustonHoustonTX 77033United States

BACKGROUND Anastomotic leak(AL) after low anterior resection(LAR) can be a highly morbid *** incidence of AL ranges from 5% to 20% depending on patient characteristics and the distance of the anastomosis from the anal *** anastomoses and leaks pose technical challenges for endoscopic *** aim of this report was to describe the use of a commercially available laparoscopic energy device through a transanal minimally invasive surgery(TAMIS) port for the management of a symptomatic leak not requiring relaparotomy(grade B) after a LAR with diverting loop *** SUMMARY A TAMIS GelPOINT Path port was inserted into the anus to access the distal *** was achieved with AirSeal insufflation and a 30 degree laparoscope was introduced through a trocar.A LigaSure TM Retractable L-Hook device was then used to perform a septotomy of the chronic sinus tract identified posterior to the *** procedure was then repeated twice in three weeks intervals with ultimate resolution of the chronic leak *** months after serial TAMIS septotomies,barium enema demonstrated a patent anastomosis with no evidence of persistent leak or *** patient subsequently underwent ileostomy reversal and has had no significant postoperative *** TAMIS septotomy with the LigaSure TM Retractable L-Hook is a feasible andeffective,minimally invasive salvage technique for the treatment of grade B *** studies are needed to assess the generalizability and long-term results of this technique.

关键词： transanal minimally invasive surgery Ligasure hook Anastomotic leak Low anterior resection Septotomy Case report

Meta-analysis of transanal vs laparoscopic total mesorectal excision of low rectal cancer:Importance of appropriate patient selection

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Surgery 2022年第12期14卷 1397-1410页

作者： Pratik Bhattacharya Ishaan Patel Noureen Fazili Shahab Hajibandeh Shahin Hajibandeh Department of Surgery Sandwell and West Birmingham Hospitals NHS TrustBirmingham B714HJUnited Kingdom Department of Surgery Queen Elizabeth Hospital BirminghamBirmingham B152GWUnited Kingdom Department of Surgery University Hospital of WalesCardiff CF144XWUnited Kingdom Department of Surgery Royal Stoke University HospitalStoke-on-Trent ST46QGUnited Kingdom

BACKGROUND Achieving a clear resection margins for low rectal cancer is technically *** approach to total mesorectal excision(TME)was introduced in order to address the challenges associated with the laparoscopic approach in treating low rectal ***,previous meta-analyses have included mixed population with mid and low rectal tumours when comparing both approaches which has made the interpretation of the real differences between two approaches in treating low rectal cancer *** To investigate the outcomes of transanal TME(TaTME)and laparoscopic TME(LaTME)in patients with low rectal *** A comprehensive systematic review of comparative studies was performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses *** and postoperative complications,anastomotic leak,R0 resection,completeness of mesorectal excision,circumferential resection margin(CRM),distal resection margin(DRM),harvested lymph nodes,and operation time were the investigated outcome *** We included twelve comparative studies enrolling 969 patients comparing TaTME(n=969)and LaTME(n=476)in patients with low rectal *** was associated with significantly lower risk of postoperative complications(OR:0.74,P=0.04),anastomotic leak(OR:0.59,P=0.02),and conversion to an open procedure(OR:0.29,P=0.002)in comparison with ***,the rate of R0 resection was significantly higher in the TaTME group(OR:1.96,P=0.03).Nevertheless,TaTME and LaTME were comparable in terms of rate of intraoperative complications(OR:1.87;P=0.23),completeness of mesoractal excision(OR:1.57,P=0.15),harvested lymph nodes(MD:-0.05,P=0.96),DRM(MD:-0.94;P=0.17),CRM(MD:1.08,P=0.17),positive CRM(OR:0.64,P=0.11)and procedure time(MD:-6.99 min,P=0.45).CONCLUSION Our findings indicated that for low rectal tumours,TaTME is associated with better clinical and short term oncological outcomes compared to *** randomised controll

关键词： Total mesorectal excision Laparoscopic transanal Rectal cancer