What's new for ' Actualización TEM' in PubMed

2 views

Skip to first unread message

Rikibelda

unread,

Feb 1, 2012, 7:04:56 AM2/1/12

to actualiz...@googlegroups.com

Hola,

Os envio una nueva actualización de la bibliografía del tem,

Saludos

Ricardo Belda Lozano

MD,PhD, MS.

Master en Cirugía Laparoscópica

Master en Coloproctología

http://coloprocto.wordpress.com/

Inicio del mensaje reenviado:

De: My NCBI <efb...@mail.nih.gov>
Fecha: 1 de febrero de 2012 12:41:09 GMT+01:00
Para: <riki...@hotmail.com>
Asunto: What's new for ' Actualización TEM' in PubMed
Responder a: <riki...@hotmail.com>

This message contains My NCBI what's new results from the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).
Do not reply directly to this message.
Sender's message: Nueva Bibliografía del TEM
Sent on Wednesday, 2012 February 01
Search: "Rectum"[Mesh] OR "Rectal Neoplasms"[Mesh] AND "Microsurgery"[Mesh]

Click here to view complete results in PubMed (Results may change over time.)
To unsubscribe from these e-mail updates click here.

PubMed Results
Items 1 - 5 of 5

1. Tech Coloproctol. 2011 Sep;15(3):281-4. Epub 2011 Jun 28.
Incidence, treatment and outcome of rectal stenosis following transanal endoscopic microsurgery.
Barker JA, Hill J.
Source
Department of Surgery, Central Manchester University Hospitals, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK.
Abstract
BACKGROUND:
As an alternative to more radical abdominal surgery, transanal endoscopic microsurgery (TEM) offers a minimally invasive solution for the excision of certain rectal polyps and early-stage rectal tumours. The patient benefits of TEM as compared to radical abdominal surgery are clear; nevertheless, some drawback is possible. The aim of our study was to determine the risk factors, treatment and outcomes of rectal stenosis following TEM.
METHODS:
We analysed a series of 354 consecutive patients who underwent TEM for benign or malignant rectal tumours between 1997 and 2009. We recorded the maximum histological diameter of the lesion, and whether the lesion was circumferential. Rectal stenosis was defined as a rectal narrowing not allowing passage of a 12 mm sigmoidoscope.
RESULTS:
Histological results with a measured specimen diameter were available in 304 of the 354 cases. There were 11 stenoses in total (3.6%), 7 stenoses due to 9 circumferential lesions (78%) and 4 due to lesions with a maximum diameter ≥ 5 cm (3.2%). Two patients presented as emergencies, and the other 9 patients reported symptoms of increased stool frequency at follow-up. Three of the stenoses were associated with recurrent disease. All stenoses were treated by a combination of endoscopic/radiological balloon dilatation or surgically with Hegar's dilators. A median of two procedures were required to treat stenoses until resolution of symptoms.
CONCLUSIONS:
Rectal stenosis following TEM excision is rare. It is predictable in patients with circumferential lesions but is rare in patients with non-circumferential lesions with a maximum diameter ≥ 5 cm. It is effectively treated with surgical or balloon dilatation. Most patients require repeated treatments.
PMID:

21710207
[PubMed - indexed for MEDLINE]
Related citations

2. J Gastrointest Surg. 2011 Aug;15(8):1306-8. Epub 2011 Jun 7.
Indications and techniques of transanal endoscopic microsurgery (TEMS).
Qi Y, Stoddard D, Monson JR.
Source
Division of Colorectal Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box SURG, Rochester, NY, 14642, USA.
Abstract
Transanal endoscopic microsurgery (TEMS) has recently reemerged as a valuable technique for the management of rectal neoplasms - both benign and malignant. Since the original description of this technique in the early 1980s, TEMS has emerged as the approach of choice for most benign rectal tumors because of the excellent views provided and superior dissection techniques possible when compared to traditional transanal excision. Many published reports demonstrate that the lowest rates of recurrence are associated with TEMS probably because of full-thickness excision with negative margins. Increasingly, TEMS is being applied to primary rectal cancer when used alone as a full-thickness excision alone or in combination with additional therapies, depending on tumor stage. There is now a significant evidence base to suggest that this approach should be considered as part of a multidisciplinary approach to rectal cancer. This paper describes indications and techniques for this technology.
PMID:

21647769
[PubMed - indexed for MEDLINE]
Related citations

3. Surg Endosc. 2011 Oct;25(10):3209-13. Epub 2011 Apr 13.
Efficiency and outcomes of harmonic device in transanal endoscopic microsurgery compared with m onopolar scalpel.
Gracia JA, Ramirez JM, Callejo D, Elia M, Maeso S, Aguilella V, Martinez M.
Source
Coloproctology Unit, Department of Surgery, Hospital Clinico Universitario, Zaragoza, Spain. josegrac...@hotmail.com
Abstract
INTRODUCTION:
An important fact when facing new technologies is their cost for the Health Publishes. The purpose of this paper is to compare the costs of performing TEM with harmonic scalpel and classic monopolar scalpel and to analyze complications.
METHODS:
Operation time, blood loss, and hospital stay were recorded to determine the cost of the TEM procedure. We also recorded early and late complications. Patients were divided in two groups: harmonic scalpel group (UC) and monopolar scalpel group (MS).
RESULTS:
TEM for curative intention was used in 330 rectal tumors from January 1997 to January 2010. A total of 229 patients met the criteria for this study: UC group (n = 87) and MS group (n = 142). Patients from the UC group developed fewer complications (16%) than patients from the MS group (23%). The difference of mean stay between groups was 1.5 days (95% confidence interval, 0.7; 2.2 days; P < 0.001) in favor of the UC group.
CONCLUSIONS:
Harmonic scalpel provides a safer, easier, and more precise surgical section through clean, bloodless, and better visualized operative field. The additional cost of UC was compensated with the decrease in the health resources (mainly hospital stay).
PMID:

21487854
[PubMed - indexed for MEDLINE]
Related citations

4. Int J Colorectal Dis. 2011 Oct;26(10):1359-61. Epub 2011 Jan 20.
Neoadjuvant chemoradiation therapy followed by curative transanal endoscopic microsurg ery (TEM) for rectal cancer complicated by major suture dehiscence: avoiding ileostomy through hyperbaric oxygen therapy.
Araujo SE, Bammann RH, Seid VE, Nahas SC, Nahas CS, Cecconello I.
PMID:

21249373
[PubMed - indexed for MEDLINE]
Related citations

5. Chirurg. 2011 Jul;82(7):625-30.
[Microsurgical reconstruction of the pelvic floor after pelvic exenteration. Reduced morbidity and improved quality of l ife by an interdisciplinary concept].
[Article in German]
Stechl NM, Baumeister S, Grimm K, Kraus TW, Bockhorn H, Exner KE.
Source
Klinik für Plastische, Wiederherstellungs- und Handchirurgie, Markus-Krankenhaus, Wilhelm- Epstein-Straße 4, Frankfurt am Main, Germany. N.St...@gmx.de
Abstract
BACKGROUND:
Pelvic exenteration for advanced or recurrent rectal cancer often results in complex defects associated with high complication rates and morbidity for the patients. The goal of therapy is therefore restoration of functional stability and adequate soft tissue coverage, thus enhancing the quality of life with limited life expectancy by an interdisciplinary approach.
PATIENTS AND METHODS:
We report on eight patients treated by combined interdisciplinary pelvic exenteration with resection of the sacrum and subsequent coverage of the pelvic floor defect with free latissimus dorsi muscle flaps. All patients were treated in two stages according to a pre-established therapeutic algorithm. First, an abdominal and transsacral pelvic exenenteration was performed with an ileostomy and ileum conduit system and the pelvic floor was closed with vicryl meshes. The open wound was optimized by vacuum-assisted closure (VAC) therapy before reconstruction of the pelvic floor was undertaken 10-12 days later with free latissimus dorsi musculocutaneous flaps either anastomosed to the lower or upper gluteal vessels or to an AV-loop using the saphenous vein as connection to the groin vessels.
RESULTS:
In all cases a sufficient and stable reconstruction of the pelvic floor could be achieved and no flap loss occurred. In three patients a minor wound dehiscence occurred, which could be closed by secondary suture. The time span between the free flap transfer and stable wound closure was 19-28 days. Later complications such as fistula formation and chronic wound infections were not observed. The survival of the patients ranged from 10-36 months.
CONCLUSION:
The present two-stage concept of pelvic floor reconstruction with free latissimus dorsi muscle flaps for wound closure after pelvic exenteration improves postoperative morbidity and mortality and increases the quality of life of the affected patients. A shortened period of open wound therapy brings additional economic benefits. Because of its anatomical features the free latissimus dorsi flap can be regarded as the method of choice of microsurgical reconstruction within an interdisciplinary concept after pelvic exenteration.
PMID:

21161142
[PubMed - indexed for MEDLINE]
Related citations

Reply all

Reply to author

Forward

0 new messages

1.	Tech Coloproctol. 2011 Sep;15(3):281-4. Epub 2011 Jun 28. Incidence, treatment and outcome of rectal stenosis following transanal endoscopic microsurgery. Barker JA, Hill J. Source Department of Surgery, Central Manchester University Hospitals, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK. Abstract BACKGROUND: As an alternative to more radical abdominal surgery, transanal endoscopic microsurgery (TEM) offers a minimally invasive solution for the excision of certain rectal polyps and early-stage rectal tumours. The patient benefits of TEM as compared to radical abdominal surgery are clear; nevertheless, some drawback is possible. The aim of our study was to determine the risk factors, treatment and outcomes of rectal stenosis following TEM. METHODS: We analysed a series of 354 consecutive patients who underwent TEM for benign or malignant rectal tumours between 1997 and 2009. We recorded the maximum histological diameter of the lesion, and whether the lesion was circumferential. Rectal stenosis was defined as a rectal narrowing not allowing passage of a 12 mm sigmoidoscope. RESULTS: Histological results with a measured specimen diameter were available in 304 of the 354 cases. There were 11 stenoses in total (3.6%), 7 stenoses due to 9 circumferential lesions (78%) and 4 due to lesions with a maximum diameter ≥ 5 cm (3.2%). Two patients presented as emergencies, and the other 9 patients reported symptoms of increased stool frequency at follow-up. Three of the stenoses were associated with recurrent disease. All stenoses were treated by a combination of endoscopic/radiological balloon dilatation or surgically with Hegar's dilators. A median of two procedures were required to treat stenoses until resolution of symptoms. CONCLUSIONS: Rectal stenosis following TEM excision is rare. It is predictable in patients with circumferential lesions but is rare in patients with non-circumferential lesions with a maximum diameter ≥ 5 cm. It is effectively treated with surgical or balloon dilatation. Most patients require repeated treatments.
	PMID: 21710207 [PubMed - indexed for MEDLINE]
	Related citations

2.	J Gastrointest Surg. 2011 Aug;15(8):1306-8. Epub 2011 Jun 7. Indications and techniques of transanal endoscopic microsurgery (TEMS). Qi Y, Stoddard D, Monson JR. Source Division of Colorectal Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box SURG, Rochester, NY, 14642, USA. Abstract Transanal endoscopic microsurgery (TEMS) has recently reemerged as a valuable technique for the management of rectal neoplasms - both benign and malignant. Since the original description of this technique in the early 1980s, TEMS has emerged as the approach of choice for most benign rectal tumors because of the excellent views provided and superior dissection techniques possible when compared to traditional transanal excision. Many published reports demonstrate that the lowest rates of recurrence are associated with TEMS probably because of full-thickness excision with negative margins. Increasingly, TEMS is being applied to primary rectal cancer when used alone as a full-thickness excision alone or in combination with additional therapies, depending on tumor stage. There is now a significant evidence base to suggest that this approach should be considered as part of a multidisciplinary approach to rectal cancer. This paper describes indications and techniques for this technology.
	PMID: 21647769 [PubMed - indexed for MEDLINE]
	Related citations

3.	Surg Endosc. 2011 Oct;25(10):3209-13. Epub 2011 Apr 13. Efficiency and outcomes of harmonic device in transanal endoscopic microsurgery compared with m onopolar scalpel. Gracia JA, Ramirez JM, Callejo D, Elia M, Maeso S, Aguilella V, Martinez M. Source Coloproctology Unit, Department of Surgery, Hospital Clinico Universitario, Zaragoza, Spain. josegrac...@hotmail.com Abstract INTRODUCTION: An important fact when facing new technologies is their cost for the Health Publishes. The purpose of this paper is to compare the costs of performing TEM with harmonic scalpel and classic monopolar scalpel and to analyze complications. METHODS: Operation time, blood loss, and hospital stay were recorded to determine the cost of the TEM procedure. We also recorded early and late complications. Patients were divided in two groups: harmonic scalpel group (UC) and monopolar scalpel group (MS). RESULTS: TEM for curative intention was used in 330 rectal tumors from January 1997 to January 2010. A total of 229 patients met the criteria for this study: UC group (n = 87) and MS group (n = 142). Patients from the UC group developed fewer complications (16%) than patients from the MS group (23%). The difference of mean stay between groups was 1.5 days (95% confidence interval, 0.7; 2.2 days; P < 0.001) in favor of the UC group. CONCLUSIONS: Harmonic scalpel provides a safer, easier, and more precise surgical section through clean, bloodless, and better visualized operative field. The additional cost of UC was compensated with the decrease in the health resources (mainly hospital stay).
	PMID: 21487854 [PubMed - indexed for MEDLINE]
	Related citations

4.	Int J Colorectal Dis. 2011 Oct;26(10):1359-61. Epub 2011 Jan 20. Neoadjuvant chemoradiation therapy followed by curative transanal endoscopic microsurg ery (TEM) for rectal cancer complicated by major suture dehiscence: avoiding ileostomy through hyperbaric oxygen therapy. Araujo SE, Bammann RH, Seid VE, Nahas SC, Nahas CS, Cecconello I.
	PMID: 21249373 [PubMed - indexed for MEDLINE]
	Related citations

5.	Chirurg. 2011 Jul;82(7):625-30. [Microsurgical reconstruction of the pelvic floor after pelvic exenteration. Reduced morbidity and improved quality of l ife by an interdisciplinary concept]. [Article in German] Stechl NM, Baumeister S, Grimm K, Kraus TW, Bockhorn H, Exner KE. Source Klinik für Plastische, Wiederherstellungs- und Handchirurgie, Markus-Krankenhaus, Wilhelm- Epstein-Straße 4, Frankfurt am Main, Germany. N.St...@gmx.de Abstract BACKGROUND: Pelvic exenteration for advanced or recurrent rectal cancer often results in complex defects associated with high complication rates and morbidity for the patients. The goal of therapy is therefore restoration of functional stability and adequate soft tissue coverage, thus enhancing the quality of life with limited life expectancy by an interdisciplinary approach. PATIENTS AND METHODS: We report on eight patients treated by combined interdisciplinary pelvic exenteration with resection of the sacrum and subsequent coverage of the pelvic floor defect with free latissimus dorsi muscle flaps. All patients were treated in two stages according to a pre-established therapeutic algorithm. First, an abdominal and transsacral pelvic exenenteration was performed with an ileostomy and ileum conduit system and the pelvic floor was closed with vicryl meshes. The open wound was optimized by vacuum-assisted closure (VAC) therapy before reconstruction of the pelvic floor was undertaken 10-12 days later with free latissimus dorsi musculocutaneous flaps either anastomosed to the lower or upper gluteal vessels or to an AV-loop using the saphenous vein as connection to the groin vessels. RESULTS: In all cases a sufficient and stable reconstruction of the pelvic floor could be achieved and no flap loss occurred. In three patients a minor wound dehiscence occurred, which could be closed by secondary suture. The time span between the free flap transfer and stable wound closure was 19-28 days. Later complications such as fistula formation and chronic wound infections were not observed. The survival of the patients ranged from 10-36 months. CONCLUSION: The present two-stage concept of pelvic floor reconstruction with free latissimus dorsi muscle flaps for wound closure after pelvic exenteration improves postoperative morbidity and mortality and increases the quality of life of the affected patients. A shortened period of open wound therapy brings additional economic benefits. Because of its anatomical features the free latissimus dorsi flap can be regarded as the method of choice of microsurgical reconstruction within an interdisciplinary concept after pelvic exenteration.
	PMID: 21161142 [PubMed - indexed for MEDLINE]
	Related citations