Repair of rectal trauma perforation using transanal endoscopic operation

Serra‐Aracil, Xavier; Díaz, Carlos G. Otero; Soto, Salvador Navarro; Hidalgo-Rosas, José M.; Mora, Laura

doi:10.1111/j.1463-1318.2011.02928.x

Cited by 8 publications

(5 citation statements)

References 4 publications

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“…A case report describes the successful primary repair an impalement injury with transanal endoscopic operation without complications. 12 Our current report adds to the limited literature available on transanal repair of extraperitoneal rectal injuries.…”

Section: Discussionmentioning

confidence: 72%

Minimally invasive approach to low-velocity penetrating extraperitoneal rectal trauma

Melland-Smith

Chesney

Ashamalla

et al. 2020

Trauma Surg Acute Care Open

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Unlike intraperitoneal colorectal injuries, the standard of care for extraperitoneal rectal trauma includes a diverting colostomy due to relative inaccessibility of these injuries for primary repair. New technologies to enhance access to the extraperitoneal rectum have gained increasing use in benign and malignant rectal disease. We present two cases of low-velocity penetrating extraperitoneal rectal trauma. In both cases, a transanal minimally invasive surgery (TAMIS) approach was used to access, and primarily repair, full-thickness rectal lacerations. These patients were successfully managed without a colostomy and without complication. TAMIS enables access to distal rectal injuries, facilitating primary repair and bringing the management of extraperitoneal rectal injuries in line with intraperitoneal injuries, with the potential to avoid fecal diversion.

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Section: Discussionmentioning

confidence: 72%

Minimally invasive approach to low-velocity penetrating extraperitoneal rectal trauma

Melland-Smith

Chesney

Ashamalla

et al. 2020

Trauma Surg Acute Care Open

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“…As the time interval duration increases, the surgeon may face septic complications and the possibility of a failed primary repair or resection/anastomosis. Although successful primary repair without diversion stoma has been reported during the first 12 h,[ 36 ] appropriate operative intervention for primary repair has been recommended in the literature in the first 6–8 h.[ 35 , 37 ] Shatnawi et al[ 3 ] emphasized that complications were directly related to the presence of septic shock and delay in treatment for more than 6 h, regardless of the type of treatment. In all but one of our patients, we did not perform a diversion stoma, due to early surgical intervention (in the first 2 h).…”

Section: Discussionmentioning

confidence: 99%

Isolated recto-vaginal septum injury during parturition: Single center experience

Altıntoprak¹

2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Traumatic rectal injuries are uncommon and can originate due to various causes. Rectal injuries have a high morbidity, regardless of cause, and detection at the time of occurrence is important to prevent fistula formation and/or stoma. In this article, treatment approaches in patients with isolated rectovaginal septum injury without perineal and sphincter injury during spontaneous vaginal delivery are presented and the current literature is reviewed. METHODS: The records of spontaneous vaginal deliveries that resulted in live births between January 2015 and January 2020 were analyzed retrospectively at our center. The records of patients with isolated rectovaginal septum injury were evaluated in terms of demographic and obstetric data, trauma, classification of injury, and early and late results. RESULTS: Isolated septum injuries were detected 12 women (0.06%). Of the isolated rectovaginal septum injuries, 9 (75%) were classified as Type III, 2 (16.6%) as Type IV, and 1 (8.3%) as a Type V injury according to the Rosenshein classification. Transvaginal repair was performed because all of the injuries underwent early surgical intervention, were limited, and exploration through the vagina was possible. CONCLUSION: Rectal examination should be performed simultaneously with a detailed perineal examination after vaginal delivery. For birth-related rectal injuries detected early in appropriate patients, a primary repair without diversion stoma may be the best option.

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“…A follow-on study by the same group echoed these results, and for the first time questioned the role of routine presacral drainage if the rectal injury was able to be repaired. 21 This has largely remained the treatment paradigm until now, with primary repair of the intraperitoneal rectum without diversion in appropriate cases, and repair of accessible wounds of the extraperitoneal rectum without presacral drainage and with selective diversion. Distal third extraperitoneal rectal injury remains a challenge, as this anatomic region remains difficult to access from an abdominal approach.…”

Section: Rectal Traumamentioning

confidence: 99%

“…This difficulty has prompted recent descriptions of management of these wounds using a transanal endoscopic microsurgical (TEM) approach, though no large studies on this topic exist currently. 21…”

Section: Rectal Traumamentioning

confidence: 99%

Historical Perspectives on Colorectal Trauma Management

Tyler

Welling

2017

Clinics in Colon and Rectal Surgery

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The authors discuss the history and evolution of management of traumatic wounds to the colon and rectum, summarizing early management parallel with the history of armed conflict followed by the increase in research and management interest by civilian centers in the post-Vietnam era. They explore the strong opinions of the early thought-leaders such as DeBakey and Ogilvie, detailing factors that may have impacted their views. The current literature on optimal management of both colon and rectal trauma is reviewed, including the contentious debate over which patients may benefit from diversion. Current organ injury staging and clinical practice guidelines are also reviewed, as well as lessons learned by the U.S. military in recent conflicts in Iraq and Afghanistan. Understanding of the evolution of colon and rectal trauma management, as well as the current literature, will help surgeons in their decision-making and management of these challenging injuries.

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Repair of rectal trauma perforation using transanal endoscopic operation

Cited by 8 publications

References 4 publications

Minimally invasive approach to low-velocity penetrating extraperitoneal rectal trauma

Minimally invasive approach to low-velocity penetrating extraperitoneal rectal trauma

Isolated recto-vaginal septum injury during parturition: Single center experience

Historical Perspectives on Colorectal Trauma Management

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