Fwd: What's new for ' Actualización TEM' in PubMed

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Ricardo Belda Lozano

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Feb 4, 2015, 5:01:50 PM2/4/15

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Ricardo Belda Lozano

MD,PhD, MS.

Master en Cirugía Laparoscópica

Master en Coloproctología

http://coloprocto.wordpress.com/

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Fecha: 2 de febrero de 2015 00:25:27 GMT+1
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Asunto: What's new for ' Actualizaci??n TEM' in PubMed
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Sender's message: Nueva Bibliografía del TEM
Sent on Sunday, 2015 February 01
Search: "Rectum"[Mesh] OR "Rectal Neoplasms"[Mesh] AND "Microsurgery"[Mesh]

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PubMed Results
Items 1 - 5 of 5

1. Med Image Comput Comput Assist Interv. 2014;17(Pt 2):332-9.
Multi-view stereo and advanced navigation for transanal endoscopic microsurgery.
Bergeles C, Pratt P, Merrifield R, Darzi A, Yang GZ.
Abstract
Transanal endoscopic microsurgery (TEM), i.e., the local excision of rectal carcinomas by way of a bimanual operating system with magnified binocular vision, is gaining acceptance in lieu of more radical total interventions. A major issue with this approach is the lack of information on submucosal anatomical structures. This paper presents an advanced navigation system, wherein the intraoperative 3D structure is stably estimated from multiple stereoscopic views. It is registered to a preoperatively acquired anatomical volume based on subject-specific priors. The endoscope motion is tracked based on the 3D scene and its field-of-view is visualised jointly with the preoperative information. Based on in vivo data, this paper demonstrates how the proposed navigation system provides intraoperative navigation for TEM1.
PMID: 25485396 [PubMed - indexed for MEDLINE]
Related citations
2. Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Aug;17(8):809-12.
[Evaluation of anal function and quality of life after transanal endoscopic microsurgery].
[Article in Chinese]
Song Y¹, Yang G, Qiu J, Zhang X, Deng Q, Wang D.
Abstract
OBJECTIVE:
To evaluate the impact of transanal endoscopic microsurgery (TEM) on postoperative anal function and quality of life in patients with benign rectal tumor and early rectal cancer.
METHODS:
Clinical data of 50 patients with rectal adenoma and early rectal cancer undergoing transanal endoscopic microsurgery in our hospital from October 2008 to June 2013 were retrospectively analyzed. Anorectal manometry, endorectal ultrasonography (ERUS), the fecal incontinence severity index (FISI), and the physical and mental health status scores (SF-36) were used to evaluate preoperative and postoperative anorectal function and quality of life.
RESULTS:
Anorectal manometry indicated anal resting pressure (ARP), maximum squeeze pressure (MSP), rectal volume at sensory threshold(RVST), maximum tolerable volume(MTV) decreased significantly at the first month after surgery (P<0.05). MSP returned to preoperative level at the 3rd month (P>0.05). ARP and MTV returned to normal values at the 6th month (P>0.05). RVST returned to normal values at the 9th month (P>0.05). Recto-anal inhibitory reflex(RAIR) was absent in 1 (2%) patient preoperatively and in 30(60%), 18(36%), 7(14%), 2(4%) at the 1st, 3rd, 6th, 9th months after surgery respectively. ERUS showed similar width and thickness of internal sphincter at 1st and 6th month after surgery compared with preoperative measures (P>0.05). Six months after surgery, the mean FISI score decreased(preoperative vs postoperative:8.5 vs 5.8, P<0.05), suggesting an improvement in fecal continence. However, the overall quality of life did not danger significantly after surgery(P>0.05).
CONCLUSIONS:
TEM has little impact on anorectal anatomic structure. Anal function may be compromised in the short-term, however the vast majority of patients recover completely after 6-9 months. TEM is a safe, effective and minimally invasive surgery.
PMID: 25164900 [PubMed - indexed for MEDLINE]
Related citations
3. Zhonghua Wei Chang Wai Ke Za Zhi. 2014 May;17(5):473-5.
[Transanal endoscopic microsurgery by transanal glove port combined with colonoscopy for excision of rectal tumors].
[Article in Chinese]
Deng Q¹, Liao X, Yang G, Mao W, Shen Z, Liu Z, Ding J, Zhang X, Yu Y.
Abstract
OBJECTIVE:
To evaluate the feasibility and efficacy of transanal endoscopic microsurgery (TEM) by transanal glove port combined with colonoscopy for excision of rectal tumors.
METHODS:
Eight patients with rectal cancer eligible for local resection were chosen to receive a procedure performed via a "glove TEM port" from October 2012 to March 2013. This device was constructed on-table using a circular anal dilator (CAD), standard surgical glove, colonoscopy instruments and straight laparoscopic instruments.
RESULTS:
Procedures of all the patients were completed successfully by glove TEM. The median (range) diameter of tumor was 2.6(1.5-3.5) cm, the median (range) operative time was 55.6(30-110) min. Postoperative pathology included villous adenomas (n=3), tubular adenomas (n=2), tubulovillous adenomas (n=2), serrated adenoma (n=1), low-grade intraepithelial neoplasia (n=2), and high-grade intraepithelial neoplasia (n=1). All resection margins were negative. Two patients presented with postoperative minor bleeding. There were no serious intraoperative complications. No cancer recurrence was found during a follow-up of 1-5 (median 3.1) months.
CONCLUSION:
Transanal endoscopic microsurgery by transanal glove port combined with colonoscopy in the treatment of early rectal cancer is easy and safe.
PMID: 24859958 [PubMed - indexed for MEDLINE]
Related citations
4. Int J Colorectal Dis. 2014 Jul;29(7):863-75. doi: 10.1007/s00384-014-1887-x. Epub 2014 May 13.
Clinical competence in the surgery of rectal cancer: the Italian Consensus Conference.
Piccoli M, Agresta F, Trapani V, Nigro C, Pende V, Campanile FC, Vettoretto N, Belluco E, Bianchi PP, Cavaliere D, Ferulano G, La Torre F, Lirici MM, Rea R, Ricco G, Orsenigo E, Barlera S, Lettieri E, Romano GM; Italian Surgical Societies Working Group.
Collaborators: Sartori CA, Mele A, Casciola L, Corcione F, D'Annibale A, De Manzini N, Doglietto GB, Leo E, Lezoche E, Marino I, Melotti G, Morino M, Presenti L, Prete F, Pugliese R, Romano GM, Santoro E, Spinoglio G, Trompetto M.
Erratum in
Int J Colorectal Dis. 2014 Aug;29(8):1029. multiple author names corrected.
Abstract
BACKGROUND AND AIM:
The literature continues to emphasize the advantages of treating patients in "high volume" units by "expert" surgeons, but there is no agreed definition of what is meant by either term. In September 2012, a Consensus Conference on Clinical Competence was organized in Rome as part of the meeting of the National Congress of Italian Surgery (I Congresso Nazionale della Chirurgia Italiana: Unità e valore della chirurgia italiana). The aims were to provide a definition of "expert surgeon" and "high-volume facility" in rectal cancer surgery and to assess their influence on patient outcome.
METHOD:
An Organizing Committee (OC), a Scientific Committee (SC), a Group of Experts (E) and a Panel/Jury (P) were set up for the conduct of the Consensus Conference. Review of the literature focused on three main questions including training, "measuring" of quality and to what extent hospital and surgeon volume affects sphincter-preserving procedures, local recurrence, 30-day morbidity and mortality, survival, function, choice of laparoscopic approach and the choice of transanal endoscopic microsurgery (TEM).
RESULTS AND CONCLUSION:
The difficulties encountered in defining competence in rectal surgery arise from the great heterogeneity of the parameters described in the literature to quantify it. Acquisition of data is difficult as many articles were published many years ago. Even with a focus on surgeon and hospital volume, it is difficult to define their role owing to the variability and the quality of the relevant studies.
PMID: 24820678 [PubMed - indexed for MEDLINE]
Related citations

5. Tech Coloproctol. 2014 Jun;18(6):521-7. doi: 10.1007/s10151-013-1069-9. Epub 2013 Sep 21.
Transanal endoscopic microsurgery for giant polyps of the rectum.
Levic K¹, Bulut O, Hesselfeldt P.
Abstract
BACKGROUND:
The potential for malignancy in rectal polyps increases with the size of the polyp, and unexpected malignancy is reported in up to 39 % of large rectal adenomas. Transanal endoscopic microsurgery (TEM) offers the possibility of an en bloc full-thickness excision for lesions in the rectum. We present our results with TEM in the removal of giant polyps equal or greater than 4 cm in diameter.
METHODS:
In the period between 1998 and 2012, TEM was performed in 39 patients with rectal polyps measuring at least 4 cm in diameter. Transrectal ultrasound and/or magnetic resonance imaging of the rectum was used when cancer was suspected.
RESULTS:
The polyp was removed with en bloc full-thickness excision in 77 % (n = 30). The preoperative diagnosis was benign rectal adenoma in 89.7 % (n = 35). The median size of the polyps was 30 cm(2) (range 16-100 cm(2)). Postoperative complications included bleeding in 4 patients (10.3 %). Histological examination showed unexpected cancer in 4 patients (10.3 %). TEM was curative in 2 of these patients, and the other 2 underwent further surgery. Recurrences occurred in 10 patients (25.6 %) and consisted of 5 adenomas and 5 adenocarcinomas. In 5 patients, these recurrences were treated with endoscopic removal or re-TEM. The remaining 5 underwent total mesorectal excision and/or chemotherapy.
CONCLUSIONS:
Full-thickness TEM provides a safe and efficient treatment for excision of giant polyps. In case of unexpected cancer, TEM can be curative. Local recurrence can be often treated with a second TEM procedure.
PMID: 24057356 [PubMed - indexed for MEDLINE]
Related citations

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1.	Med Image Comput Comput Assist Interv. 2014;17(Pt 2):332-9. Multi-view stereo and advanced navigation for transanal endoscopic microsurgery. Bergeles C, Pratt P, Merrifield R, Darzi A, Yang GZ. Abstract Transanal endoscopic microsurgery (TEM), i.e., the local excision of rectal carcinomas by way of a bimanual operating system with magnified binocular vision, is gaining acceptance in lieu of more radical total interventions. A major issue with this approach is the lack of information on submucosal anatomical structures. This paper presents an advanced navigation system, wherein the intraoperative 3D structure is stably estimated from multiple stereoscopic views. It is registered to a preoperatively acquired anatomical volume based on subject-specific priors. The endoscope motion is tracked based on the 3D scene and its field-of-view is visualised jointly with the preoperative information. Based on in vivo data, this paper demonstrates how the proposed navigation system provides intraoperative navigation for TEM1.
	PMID: 25485396 [PubMed - indexed for MEDLINE]
	Related citations

2.	Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Aug;17(8):809-12. [Evaluation of anal function and quality of life after transanal endoscopic microsurgery]. [Article in Chinese] Song Y¹, Yang G, Qiu J, Zhang X, Deng Q, Wang D. Abstract OBJECTIVE: To evaluate the impact of transanal endoscopic microsurgery (TEM) on postoperative anal function and quality of life in patients with benign rectal tumor and early rectal cancer. METHODS: Clinical data of 50 patients with rectal adenoma and early rectal cancer undergoing transanal endoscopic microsurgery in our hospital from October 2008 to June 2013 were retrospectively analyzed. Anorectal manometry, endorectal ultrasonography (ERUS), the fecal incontinence severity index (FISI), and the physical and mental health status scores (SF-36) were used to evaluate preoperative and postoperative anorectal function and quality of life. RESULTS: Anorectal manometry indicated anal resting pressure (ARP), maximum squeeze pressure (MSP), rectal volume at sensory threshold(RVST), maximum tolerable volume(MTV) decreased significantly at the first month after surgery (P<0.05). MSP returned to preoperative level at the 3rd month (P>0.05). ARP and MTV returned to normal values at the 6th month (P>0.05). RVST returned to normal values at the 9th month (P>0.05). Recto-anal inhibitory reflex(RAIR) was absent in 1 (2%) patient preoperatively and in 30(60%), 18(36%), 7(14%), 2(4%) at the 1st, 3rd, 6th, 9th months after surgery respectively. ERUS showed similar width and thickness of internal sphincter at 1st and 6th month after surgery compared with preoperative measures (P>0.05). Six months after surgery, the mean FISI score decreased(preoperative vs postoperative:8.5 vs 5.8, P<0.05), suggesting an improvement in fecal continence. However, the overall quality of life did not danger significantly after surgery(P>0.05). CONCLUSIONS: TEM has little impact on anorectal anatomic structure. Anal function may be compromised in the short-term, however the vast majority of patients recover completely after 6-9 months. TEM is a safe, effective and minimally invasive surgery.
	PMID: 25164900 [PubMed - indexed for MEDLINE]
	Related citations

3.	Zhonghua Wei Chang Wai Ke Za Zhi. 2014 May;17(5):473-5. [Transanal endoscopic microsurgery by transanal glove port combined with colonoscopy for excision of rectal tumors]. [Article in Chinese] Deng Q¹, Liao X, Yang G, Mao W, Shen Z, Liu Z, Ding J, Zhang X, Yu Y. Abstract OBJECTIVE: To evaluate the feasibility and efficacy of transanal endoscopic microsurgery (TEM) by transanal glove port combined with colonoscopy for excision of rectal tumors. METHODS: Eight patients with rectal cancer eligible for local resection were chosen to receive a procedure performed via a "glove TEM port" from October 2012 to March 2013. This device was constructed on-table using a circular anal dilator (CAD), standard surgical glove, colonoscopy instruments and straight laparoscopic instruments. RESULTS: Procedures of all the patients were completed successfully by glove TEM. The median (range) diameter of tumor was 2.6(1.5-3.5) cm, the median (range) operative time was 55.6(30-110) min. Postoperative pathology included villous adenomas (n=3), tubular adenomas (n=2), tubulovillous adenomas (n=2), serrated adenoma (n=1), low-grade intraepithelial neoplasia (n=2), and high-grade intraepithelial neoplasia (n=1). All resection margins were negative. Two patients presented with postoperative minor bleeding. There were no serious intraoperative complications. No cancer recurrence was found during a follow-up of 1-5 (median 3.1) months. CONCLUSION: Transanal endoscopic microsurgery by transanal glove port combined with colonoscopy in the treatment of early rectal cancer is easy and safe.
	PMID: 24859958 [PubMed - indexed for MEDLINE]
	Related citations

4.	Int J Colorectal Dis. 2014 Jul;29(7):863-75. doi: 10.1007/s00384-014-1887-x. Epub 2014 May 13. Clinical competence in the surgery of rectal cancer: the Italian Consensus Conference. Piccoli M, Agresta F, Trapani V, Nigro C, Pende V, Campanile FC, Vettoretto N, Belluco E, Bianchi PP, Cavaliere D, Ferulano G, La Torre F, Lirici MM, Rea R, Ricco G, Orsenigo E, Barlera S, Lettieri E, Romano GM; Italian Surgical Societies Working Group. Collaborators: Sartori CA, Mele A, Casciola L, Corcione F, D'Annibale A, De Manzini N, Doglietto GB, Leo E, Lezoche E, Marino I, Melotti G, Morino M, Presenti L, Prete F, Pugliese R, Romano GM, Santoro E, Spinoglio G, Trompetto M. Erratum in Int J Colorectal Dis. 2014 Aug;29(8):1029. multiple author names corrected. Abstract BACKGROUND AND AIM: The literature continues to emphasize the advantages of treating patients in "high volume" units by "expert" surgeons, but there is no agreed definition of what is meant by either term. In September 2012, a Consensus Conference on Clinical Competence was organized in Rome as part of the meeting of the National Congress of Italian Surgery (I Congresso Nazionale della Chirurgia Italiana: Unità e valore della chirurgia italiana). The aims were to provide a definition of "expert surgeon" and "high-volume facility" in rectal cancer surgery and to assess their influence on patient outcome. METHOD: An Organizing Committee (OC), a Scientific Committee (SC), a Group of Experts (E) and a Panel/Jury (P) were set up for the conduct of the Consensus Conference. Review of the literature focused on three main questions including training, "measuring" of quality and to what extent hospital and surgeon volume affects sphincter-preserving procedures, local recurrence, 30-day morbidity and mortality, survival, function, choice of laparoscopic approach and the choice of transanal endoscopic microsurgery (TEM). RESULTS AND CONCLUSION: The difficulties encountered in defining competence in rectal surgery arise from the great heterogeneity of the parameters described in the literature to quantify it. Acquisition of data is difficult as many articles were published many years ago. Even with a focus on surgeon and hospital volume, it is difficult to define their role owing to the variability and the quality of the relevant studies.
	PMID: 24820678 [PubMed - indexed for MEDLINE]
	Related citations

5.	Tech Coloproctol. 2014 Jun;18(6):521-7. doi: 10.1007/s10151-013-1069-9. Epub 2013 Sep 21. Transanal endoscopic microsurgery for giant polyps of the rectum. Levic K¹, Bulut O, Hesselfeldt P. Abstract BACKGROUND: The potential for malignancy in rectal polyps increases with the size of the polyp, and unexpected malignancy is reported in up to 39 % of large rectal adenomas. Transanal endoscopic microsurgery (TEM) offers the possibility of an en bloc full-thickness excision for lesions in the rectum. We present our results with TEM in the removal of giant polyps equal or greater than 4 cm in diameter. METHODS: In the period between 1998 and 2012, TEM was performed in 39 patients with rectal polyps measuring at least 4 cm in diameter. Transrectal ultrasound and/or magnetic resonance imaging of the rectum was used when cancer was suspected. RESULTS: The polyp was removed with en bloc full-thickness excision in 77 % (n = 30). The preoperative diagnosis was benign rectal adenoma in 89.7 % (n = 35). The median size of the polyps was 30 cm(2) (range 16-100 cm(2)). Postoperative complications included bleeding in 4 patients (10.3 %). Histological examination showed unexpected cancer in 4 patients (10.3 %). TEM was curative in 2 of these patients, and the other 2 underwent further surgery. Recurrences occurred in 10 patients (25.6 %) and consisted of 5 adenomas and 5 adenocarcinomas. In 5 patients, these recurrences were treated with endoscopic removal or re-TEM. The remaining 5 underwent total mesorectal excision and/or chemotherapy. CONCLUSIONS: Full-thickness TEM provides a safe and efficient treatment for excision of giant polyps. In case of unexpected cancer, TEM can be curative. Local recurrence can be often treated with a second TEM procedure.
	PMID: 24057356 [PubMed - indexed for MEDLINE]
	Related citations