Literature DB >> 27668073

Transanal endoscopic microsurgery as optimal option in treatment of rare rectal lesions: A single centre experience.

Monica Ortenzi1, Roberto Ghiselli1, Maria Michela Cappelletti Trombettoni1, Luca Cardinali1, Mario Guerrieri1.   

Abstract

AIM: To analyze the outcomes of transanal endoscopic microsurgery (TEM) in the treatment of rare rectal condition like mesenchymal tumors, condylomas, endometriosis and melanoma.
METHODS: We retrospectively reviewed a twenty-three years database. Fifty-two patients were enrolled in this study. The lesions were considered suitable for TEM if they were within 20 cm from the anus. All of them underwent an accurate preoperative workup consisting in clinical examination, total colonoscopy with biopsies, endoscopic ultrasonography, and pelvic computerized tomography or pelvic magnetic resonance imaging. Operative time, intraoperative complications, rate of conversion, tumor size, postoperative morbidity, mortality, the length of hospital stay, local and distant recurrence were analyzed.
RESULTS: Among the 1328 patients treated by TEM in our department, the 52 patients with rectal abnormalities other than adenoma or adenocarcinoma represented 4.4%. There were 30 males (57.7%) and 22 females (42.3%). Mean age was 55 years (median = 60, range = 24-78). This series included 14 (26.9%) gastrointestinal stromal tumors, 21 neuroendocrine tumors (40.4%), 1 ganglioneuroma (1.9%), 2 solitary ulcers in the rectum (3.8%), 6 cases of rectal endometriosis (11.5%), 6 cases of rectal condylomatosis (11.5%) and 2 rectal melanomas (3.8%). Mean lesion diameter was 2.7 cm (median: 4, range: 0.4-8). Mean distance from the anal verge was 9.5 cm (median: 10, range: 4-15). One patient operated for rectal melanoma developed distant metastases and died two years after the operation. We experienced 2 local recurrences (3.8%) with an overall survival equal to 97.6% (95%CI: 95%-99%) at the end of follow-up and a disease free survival of 98% (95%CI: 96%-99%).
CONCLUSION: We could conclude that TEM is an important therapeutical option for rectal rare conditions.

Entities:  

Keywords:  Full-thickness excision; Minimally invasive surgery; Rare rectal conditions; Retrospective study; Transanal endoscopic microsurgery

Year:  2016        PMID: 27668073      PMCID: PMC5027033          DOI: 10.4253/wjge.v8.i17.623

Source DB:  PubMed          Journal:  World J Gastrointest Endosc


  22 in total

1.  Excellent prognosis following endoscopic resection of patients with rectal neuroendocrine tumors despite the frequent presence of lymphovascular invasion.

Authors:  Masau Sekiguchi; Shigeki Sekine; Taku Sakamoto; Yosuke Otake; Takeshi Nakajima; Takahisa Matsuda; Hirokazu Taniguchi; Ryoji Kushima; Yuichiro Ohe; Yutaka Saito
Journal:  J Gastroenterol       Date:  2015-05-05       Impact factor: 7.527

2.  Full-thickness excision using transanal endoscopic microsurgery for treatment of rectal neuroendocrine tumors.

Authors:  Wei-Jie Chen; Nan Wu; Jiao-Lin Zhou; Guo-Le Lin; Hui-Zhong Qiu
Journal:  World J Gastroenterol       Date:  2015-08-14       Impact factor: 5.742

3.  An uncommon combination of polyps.

Authors:  Nicolas Musquer; Céline Bossard; Emmanuel Coron
Journal:  Gastroenterology       Date:  2014-07-23       Impact factor: 22.682

4.  The implementation of a transanal endoscopic microsurgery programme: initial experience with surgical performance.

Authors:  R M Helewa; A N Rajaee; I Raiche; L Williams; M Paquin-Gobeil; R P Boushey; H Moloo
Journal:  Colorectal Dis       Date:  2016-11       Impact factor: 3.788

5.  Endoscopic resection yields reliable outcomes for small rectal neuroendocrine tumors.

Authors:  Joon Han Jeon; Dae Young Cheung; Seong Jin Lee; Hyun Jin Kim; Hye Kang Kim; Hyung Jun Cho; In Kyu Lee; Jin Il Kim; Soo-Heon Park; Jae Kwang Kim
Journal:  Dig Endosc       Date:  2014-01-22       Impact factor: 7.559

Review 6.  The treatment of rectal endometriosis and the role of laparoscopic surgery.

Authors:  Hisham Haggag; Erich Solomayer; Ingolf Juhasz-Böss
Journal:  Curr Opin Obstet Gynecol       Date:  2011-08       Impact factor: 1.927

7.  Feasibility of salvage endoscopic mucosal resection by using a cap for remnant rectal carcinoids after primary EMR.

Authors:  Soung Min Jeon; Jin Ha Lee; Sung Pil Hong; Tae Il Kim; Won Ho Kim; Jae Hee Cheon
Journal:  Gastrointest Endosc       Date:  2011-02-12       Impact factor: 9.427

8.  Sphincter-sparing local excision and adjuvant radiation for anal-rectal melanoma.

Authors:  Matthew T Ballo; Jeffrey E Gershenwald; Gunar K Zagars; Jeffrey E Lee; Paul F Mansfield; Eric A Strom; Agop Y Bedikian; Kevin B S Kim; Nicholas E Papadopoulos; Victor G Prieto; Merrick I Ross
Journal:  J Clin Oncol       Date:  2002-12-01       Impact factor: 44.544

9.  Gastrointestinal stromal tumor of the rectum: results of surgical and multimodality therapy in the era of imatinib.

Authors:  Jens Jakob; Chiara Mussi; Ulrich Ronellenfitsch; Eva Wardelmann; Tiziana Negri; Alessandro Gronchi; Peter Hohenberger
Journal:  Ann Surg Oncol       Date:  2012-09-11       Impact factor: 5.344

10.  Clinical, pathologic, and immunohistochemical characteristics of gastrointestinal stromal tumors of the colon and rectum: implications for surgical management and adjuvant therapies.

Authors:  Imran Hassan; Y Nancy You; Eric J Dozois; Roman Shayyan; Thomas C Smyrk; Scott H Okuno; John H Donohue
Journal:  Dis Colon Rectum       Date:  2006-05       Impact factor: 4.585

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  3 in total

Review 1.  Diagnosis and Management of Rectal Neuroendocrine Tumors (NETs).

Authors:  Francesco Maione; Alessia Chini; Marco Milone; Nicola Gennarelli; Michele Manigrasso; Rosa Maione; Gianluca Cassese; Gianluca Pagano; Francesca Paola Tropeano; Gaetano Luglio; Giovanni Domenico De Palma
Journal:  Diagnostics (Basel)       Date:  2021-04-25

Review 2.  Rectal neuroendocrine tumors: Current advances in management, treatment, and surveillance.

Authors:  Camilla Gallo; Roberta Elisa Rossi; Federica Cavalcoli; Federico Barbaro; Ivo Boškoski; Pietro Invernizzi; Sara Massironi
Journal:  World J Gastroenterol       Date:  2022-03-21       Impact factor: 5.742

3.  Endoscopic full thickness resection vs. transanal endoscopic microsurgery for local treatment of rectal neuroendocrine tumors - a retrospective analysis.

Authors:  Markus Brand; Stanislaus Reimer; Joachim Reibetanz; Sven Flemming; Marko Kornmann; Alexander Meining
Journal:  Int J Colorectal Dis       Date:  2020-11-19       Impact factor: 2.571

  3 in total

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