Short-term clinical and functional results of rectal wall suture defect after transanal endoscopic microsurgery—a prospective cohort study

Dulskas, Audrius; Petrauskas, Vidas; Kavaliauskas, Povilas; Šapoka, Virginijus; Samalavičius, Narimantas Evaldas

doi:10.1007/s00423-022-02476-x

Cited by 1 publication

(1 citation statement)

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“…Fever could be related to transient aerosol dissemination of enteric bacteria trough the fascial spaces. Asymptomatic fever with no clinical evidence of infectious site has been described also in patients not presenting with pneumoretroperitoneum or subcutaneous emphysema, showing a self-limited trend with resolution within 2-3 days [50,54,66,88].…”

Section: Pneumoretroperitoneummentioning

confidence: 96%

Local Excision for the Management of Early Rectal Cancer

Quaresima¹,

Palmieri²,

Balla³

et al. 2024

Current Concepts and Controversies in Laparoscopic Surgery

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Transanal endoscopic microsurgery (TEM) is a minimally invasive technique introduced in the 1980s to overcome the technical difficulties in the management of low rectal tumors. The TEM system includes a dedicated rigid rectoscope and platform with a dedicated expensive instrumentation. The transanal minimally invasive surgery (TAMIS) technique was introduced to overcome these limitations. Transanal surgery consists of three main steps: exposure of the lesion, tumor excision, and defect closure. Traditional indications are benign adenomas and selected T1 rectal cancers. However, when combined with neoadjuvant chemoradiotherapy (n-CRT), the indications may be extended to patients with selected T2-T3 rectal cancers responsive to n-CRT. Intraoperative complications may be difficult to deal with, but peritoneal entry is adequately managed by endoluminal direct closure of the defect by expert surgeons. Concerning the indications for defect closure, there is no evidence of better results to prevent complications such as bleeding; the indication for defect closure should be evaluated according to multiple variables. The management of other complications is safe and does not affect TEM’s oncological and functional outcomes. Transanal excision of rectal tumor is a safe and effective alternative to conventional resection to avoid the low anterior resection syndrome, with comparable oncological results and with the advantages of an organ-sparing strategy for better patients’ QoL.

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Section: Pneumoretroperitoneummentioning

confidence: 96%