Transanal endoscopic microsurgery for rectal cancer at the 3rd Surgical Clinic of the 1st Faculty of Medicine, Charles University and the University Hospital in Motol in 2008–2013
Authors:
J. Skořepa 1
; J. Pastor 1
; P. Hladík 1
; O. Polanecký 1; M. Šnajdauf 1; M. Smejkal 1; M. Grega 2; O. Naňka 3; S. Adámek 1
Authors place of work:
III. chirurgická klinika 1. LF UK a FN v Motole, Praha
1; Ústav patologie a molekulární medicíny, 2. LF. UK a FN v Motole, Praha
2; Anatomický ústav, 1. LF UK, Praha
3
Published in the journal:
Gastroent Hepatol 2014; 68(5): 417-423
Category:
Gastrointestinal Oncology: Original Article
doi:
https://doi.org/10.14735/amgh2014417
Summary
Transanal endoscopic microsurgery (TEM) enables the surgeon to perform precise local excision of local rectal tumorous lesions. This technique requiring a specialized surgeon with extensive experience, was significantly simplified after the introduction of the harmonic scalpel. In a group of 54 patients treated with this TEM technique between 2008 and 2013, 25 had rectal carcinoma. In 40% of these 25 patients, the final diagnosis was based on a histological examination of a resected specimen postsurgically. Recurrent carcinomas were identified in three cases within one year. TEM is an accepted treatment modality of rectal carcinomas in elderly polymorbid high risk patients. Local treatment of endosonographically and bioptically verified T1N0 carcinomas in patients who are able to undergo surgical resection treatment is still controversial.
Key words:
transanal endoscopic microsurgery – rectal adenoma – early rectal carcinoma
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.
Submitted:
19. 1. 2014
Accepted:
8. 9. 2014
Zdroje
1. Anděl P, Pelikán A, Dostalík J et al. Transanální endoskopická mikrochirurgie ve FNO Ostrava na souboru pacientů. Miniivazívna chirugia a endoskopia 2007; 11(1): 5–9.
2. Anděl P, Pelikán J, Dostalík O et al. Mění použití harmonického skalpelu v TEM indikační kritéria v chirurgické terapii nízce uloženého karcinomu rekta? Miniivazívna chirugia a endoskopia 2008; 12(2): 9–11.
3. Kneist W, Terzic A, Burghardt J et al. Selection of patients with rectal tumors for local excision based on preoperative diagnosis. Results of a consecutive evaluation study of 552 patients. Chirurg 2004; 75(2): 168–175.
4. Kala Z, Kysela P, Ostřížková L et al. Chirurgická a miniinvazivní léčba kolorektálního karcinomu. Onkologie 2011; 5(5): 270–273.
5. Lips EH, van Eijk R, de Graaf EJ et al. Progression and tumor heterogeneity analysis in early rectal cancer. Clin Cancer Res 2008; 14(3): 772–781. doi: 10.1158/1078-0432.CCR-07-2052.
6. Ashraf S, Hompes R, Slater A et al. A critical appraisal of endorectal ultrasound and transanal endoscopic microsurgery and decision-making in early rectal cancer. Colorectal Dis 2012; 14(7): 821–826. doi: 10.1111/j.1463-1318.2011.02830.x.
7. Zorcolo L, Fantola G, Cabras F et al. Preoperative staging of patients with rectal tumors suitable for transanal endoscopic microsurgery (TEM): comparison of endorectal ultrasound and histopathologic findings. Surg Endosc 2009; 23(6): 1384–1389. doi: 10.1007/s00464-009-0349-y.
8. Kikuchi R, Takano M, Takagi K et al. Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines. Dis Colon Rectum 1995; 38(12): 1286–1295.
9. Langer C, Liersch T, Süss M et al. Surgical cure for early rectal carcinoma and large adenoma: transanal endoscopic microsurgery (using ultrasound or electrosurgery) compared to conventional local and radical resection. Int J Colorectal Dis 2003; 18(3): 222–229.
10. De Graaf EJ, Doornebosch PG, Tollenaar RA et al. Transanal endoscopic microsurgery versus total mesorectal excision of T1 rectal adenocarcinomas with curative intention. Eur J Surg Oncol 2009; 35(12): 1280–1285. doi: 10.1016/j.ejso.2009.05.001.
11. Morino M, Allaix ME, Caldart M et al. Risk factors for recurrence after transanal endoscopic microsurgery for rectal malignant neoplasm. Surg Endosc 2011; 25(11): 3683–3690. doi: 10.1007/s00464-011-1777-z.
12. Cocilovo C, Smith LE, Stahl T et al. Transanal endoscopic excision of rectal adenomas. Surg Endosc 2003; 17(9): 1461–1463.
13. Endreseth BH, Wibe A, Svinsas M et al. Postoperative morbidity and recurrence after local excision of rectal adenomas and rectal cancer by transanal endoscopic microsurgery. Colorectal Dis 2005; 7(2): 133–137.
14. Starý L, Klementa I, Zbořil P et al. Možnosti transanální endoskopické mikrochirurgické techniky. Rozhl Chir 2010; 89: 770–773.
15. Ondrák M, Šefr R, Eber Z. Transanální endoskopická mikrochirurgie a její postavení v chirurgii rekta – přehled. Rozhl Chir 2011; 90(8): 450–456.
16. Middleton PF, Sutherland LM, Maddern GJ. Transanal endoscopic microsurgery: a systematic review. Dis Colon Rectum 2005; 48(2): 270–284. doi: 10.1007/s10350-004-0804-8.
17. Doornebosch PG, Tollenaar RA, Gosselink MP et al. Quality of life after transanal endoscopic microsurgery and total mesorectal excision in early rectal cancer. Colorectal Dis 2007; 9(6): 553–558.
18. Morino M, Allaix ME. Transanal endoscopic microsurgery: what indications in 2013? Gastroenterol Rep (Oxf) 2013; 1(2): 75–84. doi: 10.1093/gastro/got012.
Štítky
Paediatric gastroenterology Gastroenterology and hepatology SurgeryČlánok vyšiel v časopise
Gastroenterology and Hepatology
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