Current Trends on the Status of Transanal Endoscopic Microsurgery

AbstractPurpose of ReviewTransanal endoscopic surgery (TES) is the standard of care for the local excision of large rectal adenomas and selected rectal cancers: an “en bloc” full-thickness local excision is performed, with limited risk of specimen fragmentation and positive resection margins, and subsequent significantly lower risk of recurrence and better survival than after conventional transanal excision with retractors. We perform a literature review a iming at assessing the current trends on the status of TES.Recent FindingsPatients undergoing TES report significantly lower rates of postoperative complications and better functional outcomes than patients who receive abdominal rectal resection with total mesorectal excision, with no adverse impact on long-term survival. To date, there are two different rigid platforms that are available to perform a TES procedure: the transanal endoscopic microsurgery (TEM) platform that was conceived by Buess in the early 1980s and the TEO (transanal endoscopic operation) platform. More recently, flexible platforms have been proposed as alternative to the rigid ones.SummaryBased on the current evidence, TEM and TEO represent the current standard of treatment for large rectal adenomas and selected rectal cancers. Large comparative studies are needed to assess the benefits of flexible platforms, considering that the wide adoption of flexible platforms might impair the quality of the local excision, mainly if performed in low-vo...
Source: Current Colorectal Cancer Reports - Category: Cancer & Oncology Source Type: research

Related Links:

ConclusionRACRS is safe in the treatment of patients with stage I –III colorectal cancer. Oncological outcome did not differ between RACRS and LCRS groups. RACRS had lower conversion and intra-operative complication rates.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionsAge, comorbidities, and lower-rectal cancer location were considered in deciding posttreatment strategy among high-risk T1CRC patients, alongside with positive vertical margin, depth, lymphovascular invasion, poor histologic grade, and budding. During the research period, there was no prognostic difference between the FU and AS groups.
Source: Journal of Gastrointestinal Cancer - Category: Cancer & Oncology Source Type: research
AbstractPurpose of ReviewEndoscopic ultrasound (EUS) is routinely utilized for evaluation of disorders of the lower gastrointestinal tract. In this review, we summarize the current status of rectal EUS in clinical practice and describe recent developments in diagnostic and therapeutic rectal EUS.Recent FindingsRecent guidelines recommend rectal EUS for rectal cancer staging as a second line modality in cases where MRI is contraindicated. Forward-viewing echoendoscopes and through the scope EUS miniprobes allow for EUS imaging of lesions through the entire colon and for evaluation beyond stenoses or luminal narrowings. EUS ...
Source: Current Gastroenterology Reports - Category: Gastroenterology Source Type: research
ConclusionsICG-FI was associated with significantly lower odds of AL in laparoscopic LAR for rectal cancer.Clinical trialThe study was registered with the Japanese Clinical Trials Registry as UMIN000032654.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Conclusions: The study demonstrates that stents offer a favorable therapeutic alternative to emergency surgery and are associated with promising short-term outcomes as well as an acceptable safety profile for AMIO. PMID: 30766628 [PubMed]
Source: Videosurgery and Other Miniinvasive Techniques - Category: Surgery Tags: Wideochir Inne Tech Maloinwazyjne Source Type: research
Conclusions: TaTME seems to be a promising method of treatment for patients with lower and middle rectal cancer. Short-term outcomes show an advantage of TaTME over laparoscopic total mesorectal excision.
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Original Articles Source Type: research
ConclusionBoth subjective and measured FI seem to be related to AL. In this study, no relation between FI and inflammatory serum markers could yet be found.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
AbstractPurpose of ReviewTransanal endoscopic surgery (TES) is the standard of care for the local excision of large rectal adenomas and selected rectal cancers: an “en bloc” full-thickness local excision is performed, with limited risk of specimen fragmentation and positive resection margins, and subsequent significantly lower risk of recurrence and better survival than after conventional transanal excision with retractors. We perform a literature review a iming at assessing the current trends on the status of TES.Recent FindingsPatients undergoing TES report significantly lower rates of postoperative complicat...
Source: Current Colorectal Cancer Reports - Category: Cancer & Oncology Source Type: research
ConclusionTaTME after full-thickness excision is a promising technique with a significantly lower risk of perforation of the rectum and better specimen quality compared to conventional completion TME.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionsTa-TME achieves a lower conversion rate to open surgery than L-LAR, thus improving patient recovery and reducing overall morbidity.Trial registrationClinicalTrials.gov Identifier: NCT02550769. Registration no. Ethical and Clinical Research Committee, Parc Taul í University Hospital: ID 2014/064.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
More News: Cancer | Cancer & Oncology | Colorectal Cancer | Lower Endoscopy | Rectal Cancers | Study