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Value of macrobiopsies and transanal endoscopic microsurgery in the histological work-up of rectal neoplasms:A retrospective study

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World Journal of Gastrointestinal Oncology 2017年第6期9卷 251-256页

作者： Guus MJ Bokkerink Gert-Jan van der Wilt Dirk de Jong Han HJM van Krieken Robert P Bleichrodt Johannes HW de Wilt Andreas JA Bremers Department of Surgery Radboud University Nijmegen Medical Center Department of Health Evidence Radboud University Nijmegen Medical Center Department of Gastroenterology Radboud Uni-versity Nijmegen Medical Center Department of Pathology Radboud University Nijmegen Medical Center Department of of Surgery Saint Francis Hospital

To evaluate a step up approach: Taking macrobiopsies and performing excision biopsies in patients with suspected rectal cancer in which biopsies taken though the flexible endoscope showed benign histology. METHODSPatients with a rectal neoplasm who underwent flexible endoscopy and biopsies were included. In case of benign biopsies rigid rectoscopy and macrobiopsies were employed. If this failed to prove malignancy, transanal endoscopic microsurgery (TEM) was used in a final effort to establish a certain preoperative diagnosis. The preoperative results were compared with the findings after surgical excision and follow up to calculate the reliability of this algorithm. RESULTSOne hundred and thirty-two patients were included. One hundred and ten patients with a carcinoma and 22 with an adenoma. Seventy-five of 110 carcinomas were proven malignant after flexible endoscopy. With the addition of rigid endoscopy and taking of macrobiopsies, this number increased to 89. Performing TEM excision biopsies further enlarged the number of proven malignancies to 100. CONCLUSIONThe step-up approach includes taking macrobiopsies through the rigid rectoscope and performing excision biopsies using transanal endoscopic microsurgery in addition to flexible endoscopy. This approach, reduced the number of missed preoperative malignant diagnoses from 32% to 9%.

关键词： Rectal cancer Histology Biopsy Macrobiopsy transanal endoscopic microsurgery Sampling error

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transanal endoscopic microsurgery:what indications in 2013?

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Gastroenterology Report 2013年第2期1卷 75-84页

作者： Mario Morino Marco E.Allaix Digestive ColorectalOncologic and Minimally Invasive SurgeryDepartment of Surgical SciencesUniversity of TurinItaly

Thanks to major advances in the field of surgical techniques and neoadjuvant chemoradiation therapy,along with more accurate pre-operative staging tools and the widespread introduction of population-based screening programs,treatment of rectal cancer has been evolving over the past few decades,moving towards a more tailored *** has brought a shift in the treatment algorithm of benign rectal lesions and selected early rectal cancers,for which today transanal endoscopic microsurgery(TEM)is accepted as an effective alternative to abdominal *** 2013,topics of controversy are the role of TEM in the treatment of more advanced rectal cancers,in cases of complete pathological response after chemoradiation therapy and the role of TEM as a platform for single-port surgery and *** article reviews the current indications for TEM and the future perspectives of this approach in the treatment of rectal tumors.

关键词： transanal endoscopic microsurgery full-thickness excision rectal adenoma early rectal cancer chemoradiation NOTES

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Treatment of rectal cancer by transanal endoscopic microsurgery: Experience with 425 patients

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World Journal of Gastroenterology 2014年第28期20卷 9556-9563页

作者： Mario Guerrieri Rosaria Gesuita Roberto Ghiselli Giovanni Lezoche Andrea Budassi Maddalena Baldarelli Department of General Surgery Università Politecnica delle Marche Interdepartmental "Epidemilogia Biostatistica e Informatica Medica (EBI)" CentreUniversità Politecnica delle Marche

AIM: To describe our experience in treating rectal cancer by transanal endoscopic microsurgery (TEM), report morbidity and mortality and oncological outcome.

关键词： Rectal cancer transanal endoscopic microsurgery Chemoradiotherapy Local excision Downstaging

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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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世界胃肠外科杂志:英文版(电子版) 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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transanal endoscopic surgery in rectal cancer

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World Journal of Gastroenterology 2014年第33期20卷 11538-11545页

作者： Xavier Serra-Aracil Laura Mora-Lopez Manel Alcantara-Moral Aleidis Caro-Tarrago Carlos Javier Gomez-Diaz Salvador Navarro-Soto Coloproctology Unit General and Digestive Surgery Service Parc Tauli University Hospital Universitat Autònoma de Barcelona 08208 Sabadell (Barcelona) Spain

Total mesorectal excision(TME) is the standard treatment for rectal cancer, but complications are frequent and rates of morbidity, mortality and genitourinary alterations are high. transanal endoscopic microsurgery(TEM) allows preservation of the anal sphincters and, via its vision system through a rectoscope, allows access to rectal tumors located as far as 20 cm from the anal verge. The capacity of local surgery to cure rectal cancer depends on the risk of lymph node invasion. This means that correct preoperative staging of the rectal tumor is necessary. Currently, local surgery is indicated for rectal adenomas and adenocarcinomas invading the submucosa, but not beyond(T1). Here we describe the standard technique for TEM, the different types of equipment used, and the technical limitations of this approach. TEM to remove rectal adenoma should be performed in the same way as if the lesion were an adenocarcinoma, due to the high percentageof infiltrating adenocarcinomas in these lesions. In spite of the generally good results with T1, some authors have published surprisingly high recurrence rates; this is due to the existence of two types of lesions, tumors with good and poor prognosis, divided according to histological and surgical factors. The standard treatment for rectal adenocarcinoma T2N0M0 is TME without adjuvant therapy. In this type of adenocarcinoma, local surgery obtains the best results when complete pathological response has been achieved with previous chemoradiotherapy. The results with chemoradiotherapy and TEM are encouraging, but the scientific evidence remains limited at present.

关键词： Rectal cancer Rectal adenocarcinoma transanal endoscopic microsurgery transanal endo-scopic surgery Colorectal cancer

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transanal minimally invasive surgery using laparoscopic instruments of the rectum:A review

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World Journal of Gastrointestinal Surgery 2021年第10期13卷 1149-1165页

作者： Myung Jo Kim Taek-Gu Lee Department of Surgery Chungbuk National University HospitalChungbuk National University College of MedicineCheongju 28644South Korea

transanal minimally invasive surgery(TAMIS)was first described in 2010 as an alternative to transanal endoscopic microsurgery(TEM).The TAMIS technique can be access to the proximal and mid-rectum for resection of benign and earlystage malignant rectal lesions and also used for noncurative intent surgery of more advanced lesions in patients who are not candidates for radical *** has a shorter learning curve,reduced device setup time,flexibility in instrument use,and versatility in application than ***,TAMIS shows similar results in a view of the operation time,conversion rate,reoperation rate,and complication to *** these reasons,TAMIS is an easily accessible,technically feasible,and cost-effective alternative to ***,TAMIS has enabled the performance of high-quality local excision of rectal lesions by many colorectal *** TAMIS becomes more broadly utilized such as pelvic abscess drainage,rectal stenosis,and treatment of anastomotic dehiscence,the acquisition of appropriate training must be ensured,and the continued assessment and assurance of outcome must be maintained.

关键词： transanal minimally invasive Rectal cancer Laparoscopic transanal excision endoscopic resection Minimally invasive surgery transanal endoscopic microsurgery

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Case report of a traumatic rectal neuroma

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Gastroenterology Report 2016年第4期4卷 331-333,I0003页

作者： Thomas Curran Vitaliy Poylin Robert Kane Anna Harris Jeffrey DGoldsmith Deborah Nagle Department of Surgery Division of Colorectal SurgeryBeth Israel Deaconess Medical CenterBostonMAUSA Department of Radiology Beth Israel Deaconess Medical CenterBostonMAUSA Department of Pathology Beth Israel Deaconess Medical CenterBostonMAUSA

Traumatic neuroma is a well-recognized complication of lower extremity amputation,yet has also been noted to occur *** report a clinical case and English-language literature review of traumatic rectal neuroma,a well-k... 详细信息

关键词： Traumatic rectal neuroma transanal endoscopic microsurgery

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Management of early rectal cancer;current surgical options and future direction

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World Journal of Gastrointestinal Surgery 2021年第7期13卷 655-667页

作者： Vijay Chavda Oliver Siaw Sanjay Chaudhri Franscois Runau Department of General Surgery Leicester General HospitalLeicester LE54PWUnited Kingdom

Rectal cancer is the second commonest cause of cancer death within the United *** of national screening programmes have resulted in a greater proportion of patients presenting with early-stage *** technique of transanal endoscopic microsurgery was first described in 1984 following which further options for local excision have emerged with transanal endoscopic operation and,more recently,transanal minimally invasive *** to the risks of local recurrence,the current role of minimally invasive techniques for local excision in the management of rectal cancer is limited to the treatment of pre-invasive disease and low risk early-stage rectal cancer(T1N0M0 disease).The roles of chemotherapy and radiotherapy for the management of early rectal cancer are yet to be fully ***,results of high-quality research such as the GRECCAR II,TESAR and STAR-TREC randomised control trials may highlight a wider role for local excision surgery in the future,when used in combination with oncological *** aim of our review is to provide an overview in the current management of early rectal cancer,the surgical options available for local excision and the future multimodal direction of early rectal cancer treatment.

关键词： Early rectal cancer transanal endoscopic microsurgery transanal endoscopic operation transanal minimally invasive surgery

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Removal of a large rectal polyp with endoscopic submucosal dissection-trans-anal rectoscopic assisted minimally invasive surgery hybrid technique:A case report

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World Journal of Gastrointestinal Surgery 2023年第12期15卷 2932-2937页

作者： Lino Polese Department of Surgery Oncology and GastroenterologyUniversity of PadovaPadova 35128Italy

BACKGROUND endoscopic submucosal dissection(ESD)can be used for the en-bloc removal of superficial rectal lesions;however,the lack of a traction system makes the procedure long and difficult in the presence of extensive *** SUMMARY A large polyp occupying 2/3 of the rectal circumference and extending 5 cm in length was removed by ESD with the help of laparoscopic forceps introduced via trans-anal rectoscopic assisted minimally invasive surgery,a disposable platform designed to aid in transanal minimally invasive *** of the polyp by forceps during the operation was dynamic,and applied at various points and in various *** polyp was removed en-bloc without complications in 1 h and 55 min.A sigmoidoscopy performed 50 d later showed normal healing without polyp *** The technique presented here could overcome the issues caused by lack of traction during ESD for rectal lesions.

关键词： endoscopic submucosal dissection Trans-anal rectoscopic assisted minimally invasive surgery transanal endoscopic microsurgery Rectal tumours Rectal polyp Case report

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