Outcomes of novel transanal operation for selected tumors in the rectum1

Maeda, Koutarou; Maruta, M.; Sato, Harunobu; Hanai, Tsunekazu; Masumori, Koji; M, Matumoto; Koide, Yuji; Matuoka, Hiroshi; Katuno, Hidetoshi

doi:10.1016/j.jamcollsurg.2004.05.268

Cited by 22 publications

(27 citation statements)

References 25 publications

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“…Surgical resection via the transanal route is possible in the lower rectum. 43,44 Therefore, the clinical signifi cance of ESD should be estimated by considering the duration of the procedure in comparison with other resections such as laparoscopic resection and surgical resection via the transanal route. There is a high possibility that a patient with a large colorectal carcinoma treated by ESD may require additional surgical resection after the postoperative pathological diagnosis.…”

Section: Perspectives On the Future Of Colorectal Esdmentioning

confidence: 99%

Colorectal endoscopic submucosal dissection: present status and future perspective, including its differentiation from endoscopic mucosal resection

2008

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Endoscopic submucosal dissection (ESD) allows en bloc resection of a lesion, irrespective of the size of the lesion. ESD has been established as a standard method for the endoscopic ablation of malignant tumors in the upper gastrointestinal (GI) tract in Japan. Although the use of ESD for colorectal lesions has been studied via clinical research, ESD is not yet established as a standard therapeutic method for colorectal lesions because colorectal carcinoma has unique pathological, organ specific characteristics that differ radically from those of the esophagus and stomach, and scope handling and control is more difficult in the colorectum than in the upper GI tract. Depending on the efficacy of endoscopic mucosal resection (EMR) and the clinicopathological characteristics of the colorectal tumor, the proposed indications for colorectal ESD are as follows: (1) lesions difficult to remove en bloc with a snare EMR, such as nongranular laterally spreading tumors (particularly the pseudo depressed type), lesions showing a type VI: pit pattern, and large lesions of the protruded type suspected to be carcinoma; (2) lesions with fibrosis due to biopsy or peristasis; (3) sporadic localized lesions in chronic inflammation such as ulcerative colitis; and (4) local residual carcinoma after EMR. Colorectal ESD is currently in the development stage, and a standard protocol will be available in the near future. We hope that colorectal tumors will be efficiently treated by a treatment method appropriately selected from among EMR, ESD, and surgical resection after precise preoperative diagnosis based on techniques such as magnifying colonoscopy.

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Section: Perspectives On the Future Of Colorectal Esdmentioning

confidence: 99%

Colorectal endoscopic submucosal dissection: present status and future perspective, including its differentiation from endoscopic mucosal resection

2008

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“…It's classically indicated for tumour located between 5 and 8 cm from the anal verge [12,19]. In our patient, the tumour size was greater than 4 cm which is a limitation for this technique in view of risk of incomplete or piecemeal resection [12].…”

Section: Discussionmentioning

confidence: 66%

“…It improves the exposure of higher lesion and permits the shortening and the invagination of the rectum. The invaginated rectum is, then, excised and anastomosed by a stapler application [19].…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Large Villous Tumours

Toughraï¹,

Mellouki²,

Kamaoui³

et al. 2013

JCR

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Abstract:Villous tumours of digestive tract are rare and pre malignant lesions. Their discovery is, usually, fortuitous during an endoscopic examination. The removal of villous tumours must be complete, because of their recurrence and degeneration potential. Large villous tumors are still a limitation for endoscopic removal and need a surgical management. High morbidity and mortality rate and functional disorders of radical surgery have led to an increasing interest in many other procedures which can expose to recurrence risk especially in rectal localization. We review the literature and report our experience in managing two cases of large villous tumours in two different localizations.

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“…Komplexe Staplertechniken sind für die transanale Abtragung geeigneter Rektumläsionen schon angewendet worden, aber nicht weit verbreitet [10]. Qureshi et al [11] beschreiben die Anwendung der Multifire-Endo-GIA-Technologie für die Resektion von Adenomen im mittleren Rektumdrittel.…”

Section: Diskussionunclassified

Erste Resektion eines kleinen Rektumkarzinoms mit einem neuen Staplerinstrument

et al. 2008

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ZusammenfassungFür die Operation größerer Polypen oder kleinerer Low-Risk-Karzinome im Rektum stehen technisch unterschiedliche Möglichkeiten zur Verfügung. Diese reichen von der einfachen transanalen Exzision und Naht bis zur transanalen mikrochirurgischen Resektion und Versorgung. Letztere sind aufwendig und stehen nicht überall zur Verfügung.Es wird eine alternative Technik vorgestellt, die es ermöglicht, mit Hilfe eines neu entwickelten gebogenen transanalen Staplersystems (Contour ® Transtar™, Fa. Ethicon Endo-Surgery) Vollwandresektionen des Rektums bei gleichzeitigem Verschluss des Defekts und tumortaktisch angemessener Handhabung des Präparats durchzufüh-ren und selbst kleinere Tumoren zu entfernen.Damit steht im Instrumentarium der transanalen Operationen ein neues Gerät zur Verfügung, um Resektionen über diesen Zugangsweg einfacher und den Defektverschluss sicherer zu machen. Schlüsselwörter: Rektumkarzinom · Vollwandexzision · Transanal · StaplerresektionAbstract Different techniques are available for the resection of larger rectal polyps or small low-risk carcinomas, ranging from simple transanal surgical excision and suture up to highly sophisticated transanal endoscopic mikrosurgical procedures.An alternative technique is presented using the innovative Contour ® Transtar™ (Ethicon Endo-Surgery), by which a full-sickness rectal wall resection can be performed with the wall defect being closed by a stapler line simultaneously. The technique presented allows resection in terms of a no-touch procedure and with adequate resection margins.

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Outcomes of novel transanal operation for selected tumors in the rectum1

Cited by 22 publications

References 25 publications

Colorectal endoscopic submucosal dissection: present status and future perspective, including its differentiation from endoscopic mucosal resection

Colorectal endoscopic submucosal dissection: present status and future perspective, including its differentiation from endoscopic mucosal resection

Surgical Management of Large Villous Tumours

Erste Resektion eines kleinen Rektumkarzinoms mit einem neuen Staplerinstrument

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