TITULO: TEM IN THE TREATMENT OF RETRORECTAL TUMORS
AUTOR y COAUTORES: Dr. Simon Daniel Duek, Dr. Haim Gilstein, Dr. Wisam Khoury
Nº DE REFERENCIA 9053
TIPO PRESENTACION: Temas Libres
CATEGORIA: Coloproctología
RESUMEN DE LA PRESENTACION:
ANTECEDENTES: Background: Transanal endoscopic microsurgery (TEM) was originally designed for local endoscopic excision of benign and low grade mucosal rectal lesions through an endoscopic system. The procedure is particularly challenging retrorectal lesions, since the tumor margins are not well-defined.
OBJETIVO: Objective: To investigate patient and surgical characteristics of TEM as treatment for retrorectal lesions.
DISEÑO: All patients in our Colorectal Unit who underwent TEM for a retrorectal lesion, between the years 2001-2011, were identified
MATERIAL Y METODO: Methods: All patients in our Colorectal Unit who underwent TEM for a retrorectal lesion, between the years 2001-2011, were identified. Their charts were reviewed and data pertaining to demographic characteristics and medical history, including tumor characteristics, were collected. Operative notes and histopathology reports were also reviewed. The adequacy of the tumor resection, i.e. attainment of free margins, endoscopic completion of the procedure, and perioperative complications, were assessed.
RESULTADOS: Results: Fifteen patients (5 female, 10 male), mean age 53.9±16.9 years, were identified. The main indications for surgery were gastrointestinal stromal tumor (5 patients) and tailgut or duplication cyst (4 patients). All procedures were completed endoscopically. The median distance from the anal verge was 7.3 cm (range 5-10), and the mean diameter of the tumors was 3±1.1 cm. The one patient in whom the margins presented tumoral involvement underwent repeated TEM. No intraoperative complications were reported. The postoperative complication rate was 13.3%, and the mean length of hospital stay 1.85±1.77 days.
CONCLUSIONES: Conclusions: TEM for retrorectal and submucosal rectal lesions is feasible and safe. A remarkably low morbidity rate and limited surgical injury favor TEM in selected patients. |
