Transanal endoscopic microsurgery in benign rectal tumors treatment
Journal Title: Хірургія України - Year 2019, Vol 0, Issue 2
Abstract
The literature review concerning various minimally invasive surgical tmethods for benign rectal tumors treatment is given. Data from leading clinics suggests that currently the main methods of adenomas treatment, including large ones, are endoscopic electroexcision through a colonoscope (endoscopic mucosal resection and endoscopic submucosal dissection), local transanal excision of the tumor and transanal endoscopic microsurgery. In addition to these techniques, transrectal resection of the rectum and transabdominal surgical interventions is used for large rectal adenomas. Most authors assess the long‑term results of endoscopic techniques for the large rectal adenomas removal (endoscopic mucosal resection) as unsatisfactory due to a dramatically increased risk for relapse coused by single‑unit resection difficulty. The dissection technique in the submucosal layer requires a lot of time, technical tools and skills, and currently requires standardization for the rectal localisation. The authors attribute to the disadvantages of benign rectal neoplasms transanal excision the limitation of the method by application for adenomas in the lower and, in part, in the mid‑ampular rectal part, which makes it impossible to adequately remove the neoplasm when the proximal edge of the tumor is above 3 — 4 cm from the dentate line and, as a result, the occurrence of a large number of local recurrences. Comparative analysis of minimally invasive with open surgical methods of large rectal adenomas was not carried out due to the high invasiveness of the latter, dependence on anesthetic management, high probability of both surgical and anesthetic complications during surgery and in the postoperative period. The published studies’ results allow evaluating transanal endoscopic microsurgery as the most effective method for advanced benign rectal epithelial tumors treatment. Transanal endoscopic microsurgery has the optimal ratio between intervention radicalism and minimal invasiveness among the existing minimally invasive methods for rectal neoplasms, which is confirmed by significant international experience.
Authors and Affiliations
Ya. P. Feleshtinsky, S. P. Zadorozhnii, V. Yu. Pirogovsky
Keywords
Related Articles
- EP ID EP609917
- DOI 10.30978/SU2019-2-100
- Views 147
- Downloads 0
The clinical course of abscesses and soft tissue phlegmon in HIV-infected patients
The aim — to study the features of the clinical course of abscesses and soft tissue phlegmon in HIV‑infected patients. Materials and methods. The clinical course analysis of the abscesses and soft tissues phlegmon in 90...
Thrombophilia, as the cause of vessels thrombosis of atypical surgical localizations
Thrombophilia is a change in the balance of the blood coagulation system, manifested by an increased tendency to thrombosis. The formation of blood clots occurs as a result of a complex interaction between the vascular e...
Modern approach to postoperative anesthesia in obstetrics and gynecology
Postoperative pain relief is still quite actual problem in medicine, particularly in obstetrics and gynaecology. The most appropriate method is the multimodal analgesia. This study describes features of multimodal analge...
Surgical treatment of renal cell carcinoma with thrombosis of inferior vena cava and right atrium
The aim — to improve the diagnosis and surgical treatment results of renal cell carcinoma, complicated with thrombosis of the inferior vena cava and right atrium. Materials and methods. The results of clinical examinati...
Component separation hernioplasty in treatment of postoperative ventral hernias
The presence of large defects in the anterior abdominal wall in patients is an important problem for surgeons, due to the complexity of the hernioplasty implementation, the need to use large mesh, high frequency of posto...