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[PMID]:28462478
[Au] Autor:Francis N; Penna M; Mackenzie H; Carter F; Hompes R; International TaTME Educational Collaborative Group
[Ad] Endereço:Department of Colorectal Surgery, Yeovil District Hospital Foundation Trust, Yeovil, Somerset, BA21 2RH, UK. nader.francis@ydh.nhs.uk.
[Ti] Título:Consensus on structured training curriculum for transanal total mesorectal excision (TaTME).
[So] Source:Surg Endosc;31(7):2711-2719, 2017 Jul.
[Is] ISSN:1432-2218
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The interest and adoption of transanal total mesorectal excision (TaTME) is growing amongst the colorectal surgical community, but there is no clear guidance on the optimal training framework to ensure safe practice for this novel operation. The aim of this study was to establish a consensus on a detailed structured training curriculum for TaTME. METHODS: A consensus process to agree on the framework of the TaTME training curriculum was conducted, seeking views of 207 surgeons across 18 different countries, including 52 international experts in the field of TaTME. The process consisted of surveying potential learners of this technique, an international experts workshop and a final expert's consensus to draw an agreement on essential elements of the curriculum. RESULTS: Appropriate case selection was strongly recommended, and TaTME should be offered to patients with mid and low rectal cancers, but not proximal rectal cancers. Pre-requisites to learn TaTME should include completion of training and accreditation in laparoscopic colorectal surgery, with prior experience in transanal surgery. Ideally, two surgeons should undergo training together in centres with high volume for rectal cancer surgery. Mentorship and multidisciplinary training were the two most important aspects of the curriculum, which should also include online modules and simulated training for purse-string suturing. Mentors should have performed at least 20 TaTME cases and be experienced in laparoscopic training. Reviewing the specimens' quality, clinical outcome data and entering data into a registry were recommended. Assessment should be an integral part of the curriculum using Global Assessment Scales, as formative assessment to promote learning and competency assessment tool as summative assessment. CONCLUSIONS: A detailed framework for a structured TaTME training curriculum has been proposed. It encompasses various training modalities and assessment, as well as having the potential to provide quality control and future research initiatives for this novel technique.
[Mh] Termos MeSH primário: Cirurgia Colorretal/educação
Currículo
Neoplasias Retais/cirurgia
Reto/cirurgia
Cirurgia Endoscópica Transanal/educação
[Mh] Termos MeSH secundário: Seres Humanos
Cooperação Internacional
Cirurgia Endoscópica Transanal/métodos
[Pt] Tipo de publicação:CONSENSUS DEVELOPMENT CONFERENCE; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1007/s00464-017-5562-5


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[PMID]:29173260
[Au] Autor:Caycedo-Marulanda A; Jiang HY; Kohtakangas EL
[Ad] Endereço:From the Department of Surgery, Health Sciences North, Sudbury, Ont. (Caycedo-Marulanda, Jiang, Kohtakangas); and the Faculty of Medicine, Northern Ontario School of Medicine, Sudbury, Ont. (Caycedo-Marulanda, Jiang, Kohtakangas).
[Ti] Título:Transanal minimally invasive surgery for benign large rectal polyps and early malignant rectal cancers: experience and outcomes from the first Canadian centre to adopt the technique.
[So] Source:Can J Surg;60(6):416-423, 2017 Dec.
[Is] ISSN:1488-2310
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Transanal minimally invasive surgery (TAMIS) has emerged as a relatively new technique in treating early cancer and benign lesion of the rectum. The technique is likely to be widely adopted, surpassing other comparable techniques owing to its simple setup and cost-effectiveness. We assessed the outcomes of TAMIS at our centre. METHODS: We retrospectively reviewed prospectively collected data on 50 patients who underwent TAMIS for benign, malignant T1 or T2 cancers that were unfit for radical surgery over a 4-year period. Outcomes, including 30-day complications and recurrence, as well as our ability to implement and integrate this technique at our centre were assessed. RESULTS: All 50 TAMIS procedures were successful. The average lesion was 7 cm from the anal verge, the average tumour size was 2.5 cm, the average duration of surgery was 73 minutes, the average length of stay was 1.1 days, and the margin negativity was 84%. Major indications in our series included 25 lesions that were too large for endoscopic resection, 14 early cancers or high-grade dysplasia, 10 margin checks postpolypectomy, 6 cases of recurrent polyposis, and 4 medically unfit patients. There were no deaths. The rate of short-term complications, including rectal bleeding, reoperation and urinary retention, was 16%. The rate of long-term complications, including anal incontinence and stenosis, was 4%. Benign and malignant recurrence rates were 2% and 6%, respectively. Overall long-term requirement for invasive procedures, low anterior resection or abdominoperineal resection, was 12%. CONCLUSION: To our knowledge, this is the first Canadian study showing TAMIS to be an efficient and safe procedure for the treatment of well-selected patients with rectal lesions. Outcomes from our centre are comparable with those found in the literature.
[Mh] Termos MeSH primário: Pólipos/cirurgia
Doenças Retais/cirurgia
Neoplasias Retais/cirurgia
Cirurgia Endoscópica Transanal
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Estadiamento de Neoplasias
Neoplasias Retais/patologia
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171222
[Lr] Data última revisão:
171222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:28742696
[Au] Autor:de Buck van Overstraeten A; Mark-Christensen A; Wasmann KA; Bastiaenen VP; Buskens CJ; Wolthuis AM; Vanbrabant K; D'hoore A; Bemelman WA; Tottrup A; Tanis PJ
[Ad] Endereço:*Department of Abdominal Surgery, University Hospital Leuven, KU Leuven, Belgium †Department of Surgery, Section of Coloproctology, Aarhus University Hospital, Aarhus, Denmark ‡Department of General Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands §KU Leuven - University of Leuven and Universiteit Hasselt, I-Biostat, Leuven, Belgium.
[Ti] Título:Transanal Versus Transabdominal Minimally Invasive (Completion) Proctectomy With Ileal Pouch-anal Anastomosis in Ulcerative Colitis: A Comparative Study.
[So] Source:Ann Surg;266(5):878-883, 2017 11.
[Is] ISSN:1528-1140
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This study aims to compare surgical outcome of transanal ileal pouch-anal anastomosis (ta-IPAA) with transabdominal minimal invasive approach in ulcerative colitis (UC), using the comprehensive complication index (CCI). BACKGROUND: Recent evolutions in rectal cancer surgery led to transanal dissection of the rectum resulting in a better exposure of the distal rectum and presumed better outcome. The same approach was introduced for patients with UC, resulting in decreased invasiveness. METHODS: All patients, undergoing minimally invasive restorative proctocolectomy in 1, 2, or 3 stages between January 2011 and September 2016 in 3 referral centers were included. Only patients who underwent either multiport, single port, single port with 1 additional port, hand-assisted, or robotic (R) laparoscopy were included in the analysis. CCI, registered during 90 days after pouch construction, was compared between the transanal and the transabdominal approach. RESULTS: Ninety-seven patients (male: 52%) with ta-IPAA were compared to 119 (male: 53%) with transabdominal IPAA. Ninety-nine (46%) patients had a defunctioning ileostomy at time of pouch construction. A 2-step model showed that the odds for postoperative morbidity were 0.52 times lower in the ta-IPAA group (95% confidence interval [0.29; 0.92] P = 0.026). In patients with morbidity, mean CCI of the transanal approach was 2.23 points lower than the transabdominal approach (95% confidence interval: [-6.64-3.36] P = 0.13), which was not significant. CONCLUSIONS: Ta-IPAA for UC is a safe procedure, resulting in fewer patients with morbidity, but comparable CCI when morbidity is present. Overall, ta-IPAA led to lower CCI scores.
[Mh] Termos MeSH primário: Colite Ulcerativa/cirurgia
Laparoscopia
Proctocolectomia Restauradora/métodos
Procedimentos Cirúrgicos Robóticos
Cirurgia Endoscópica Transanal
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1097/SLA.0000000000002395


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[PMID]:29112562
[Au] Autor:Maykel JA; Phatak UR; Suwanabol PA; Schlussel AT; Davids JS; Sturrock PR; Alavi K
[Ad] Endereço:1 Department of Colon and Rectal Surgery, University of Massachusetts Medical School, Worcester, Massachusetts 2 Department of Surgery, University of Michigan, Ann, Arbor, Michigan 3 Department of Surgery, Madigan Army Medical Center, Tacoma, Washington.
[Ti] Título:Initiation of a Transanal Total Mesorectal Excision Program at an Academic Training Program: Evaluating Patient Safety and Quality Outcomes.
[So] Source:Dis Colon Rectum;60(12):1267-1272, 2017 Dec.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Short-term results have shown that transanal total mesorectal excision is safe and effective for patients with mid to low rectal cancers. Transanal total mesorectal excision is considered technically challenging; thus, adoption has been limited to a few academic centers in the United States. OBJECTIVE: The aim of this study is to describe outcomes after the initiation of a transanal total mesorectal excision program in the setting of an academic colorectal training program. DESIGN: This is a single-center retrospective review of consecutive patients who underwent transanal total mesorectal excision from December 2014 to August 2016. SETTING: This study was conducted at an academic center with a colorectal residency program. PATIENTS: Patients with benign and malignant diseases were selected. INTERVENTION: All transanal total mesorectal excisions were performed with abdominal and perineal teams working simultaneously. OUTCOME MEASURES: The primary outcomes measured were pathologic quality, length of hospital stay, 30-day morbidity, and 30-day mortality. RESULTS: There were 40 patients (24 male). The median age was 55 years (interquartile range, 46.7-63.4) with a median BMI of 29 kg/m (interquartile range, 24.6-32.4). The primary indication was cancer (n = 30), and tumor height from the anal verge ranged from 0.5 to 15 cm. Eighty percent (n = 24) of the patients who had rectal cancer received preoperative chemoradiation. The most common procedures were low anterior resection (67.5%), total proctocolectomy (15%), and abdominoperineal resection (12.5%). Median operative time was 380 minutes (interquartile range, 306-454.4), with no change over time. For patients with malignancy, the mesorectum was complete or nearly complete in 100% of the specimens. A median of 14 lymph nodes (interquartile range, 12-17) were harvested, and 100% of the rectal cancer specimens achieved R0 status. Median length of stay was 4.5 days (interquartile range, 4-7), and there were 6 readmissions (15%). There were no deaths or intraoperative complications. LIMITATIONS: This study's limitations derive from its retrospective nature and single-center location. CONCLUSIONS: A transanal total mesorectal excision program can be safely implemented in a major academic medical center. Quality outcomes and patient safety depend on a comprehensive training program and a coordinated team approach. See Video Abstract at http://links.lww.com/DCR/A448.
[Mh] Termos MeSH primário: Avaliação de Processos e Resultados (Cuidados de Saúde)
Segurança do Paciente
Neoplasias Retais/cirurgia
Cirurgia Endoscópica Transanal/educação
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Educação de Pós-Graduação em Medicina
Feminino
Mortalidade Hospitalar
Seres Humanos
Internato e Residência
Tempo de Internação/estatística & dados numéricos
Masculino
Meia-Idade
Neoplasias Retais/mortalidade
Estudos Retrospectivos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171108
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000921


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[PMID]:28891856
[Au] Autor:Hüscher CGS; Lirici MM
[Ad] Endereço:1 Department of Surgery, Rummo Hospital, Benevento, Italy 2 Department of Surgery, San Giovanni Hospital, Rome, Italy.
[Ti] Título:Transanal Total Mesorectal Excision: Pneumodissection of Retroperitoneal Structures Eases Laparoscopic Rectal Resection.
[So] Source:Dis Colon Rectum;60(10):1109-1112, 2017 Oct.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Laparoscopic total mesorectal excision is effective and safe but often technically challenging because of inadequate exposure. Transanal total mesorectal excision was introduced to mitigate this limitation and improve the quality of mesorectal dissection in even the most challenging cases. Currently, the technique for transanal total mesorectal excision dissection is not standardized. TECHNIQUE: The sequential approach to transanal total mesorectal excision mirrors the principles of the transanal abdominal transanal procedure. It begins with the transanal step, followed by the laparoscopic step, and then the transanal total mesorectal excision. The perirectal space is entered via a full-thickness dissection of the anterior rectal wall. Carbon dioxide is left flowing, widening the embryonic planes between the mesorectal and pelvic fascias, then moving upward through the retroperitoneal space. The surgeon switches to the abdominal field and begins laparoscopic dissection, consisting of inferior mesenteric artery dissection and division, inferior mesenteric vein dissection and division, and possible splenic flexure dissection. Pneumodissection facilitates this procedure by distancing the inferior mesenteric artery from the hypogastric nerves and opening the embryonic fusion plane between the Toldt and Gerota fascias to allow faster division of the left colon lateral attachments. The operation continues with a switch to the perineal field and mesorectal excision. RESULTS: A total of 102 patients underwent transanal total mesorectal excision as described. Mean operative time was 185.0 + 87.5 minutes (range, 60-480 min), and there was no conversion to open surgery. Postoperative morbidity was 33.3%. Mortality rate at 30 days was 1.96% (2 cases). Quality of mesorectal excision according to Quirke was assessed in all of the specimens and found to be complete in 99 cases (97.1%) and nearly complete in 2.9% of cases. CONCLUSIONS: Transanal total mesorectal excision may benefit from pneumodissection, expedites the laparoscopic step, and the sequential approach facilitates the visualization of the correct dissection planes. The safety and cost-effectiveness of the procedure still warrant consideration. See Video at http://links.lww.com/DCR/A418.
[Mh] Termos MeSH primário: Adenocarcinoma
Colectomia
Laparoscopia
Complicações Pós-Operatórias
Neoplasias Retais
Cirurgia Endoscópica Transanal
[Mh] Termos MeSH secundário: Adenocarcinoma/patologia
Adenocarcinoma/cirurgia
Idoso
Colectomia/efeitos adversos
Colectomia/métodos
Pesquisa Comparativa da Efetividade
Conversão para Cirurgia Aberta/métodos
Conversão para Cirurgia Aberta/estatística & dados numéricos
Feminino
Seres Humanos
Itália
Laparoscopia/efeitos adversos
Laparoscopia/métodos
Masculino
Meia-Idade
Estadiamento de Neoplasias
Duração da Cirurgia
Avaliação de Processos e Resultados (Cuidados de Saúde)
Períneo/cirurgia
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/etiologia
Neoplasias Retais/patologia
Neoplasias Retais/cirurgia
Reto/cirurgia
Cirurgia Endoscópica Transanal/efeitos adversos
Cirurgia Endoscópica Transanal/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170912
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000893


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[PMID]:28891845
[Au] Autor:Atallah SB; DuBose AC; Burke JP; Nassif G; deBeche-Adams T; Frering T; Albert MR; Monson JRT
[Ad] Endereço:Center for Colon and Rectal Surgery, Florida Hospital, Orlando, Florida.
[Ti] Título:Uptake of Transanal Total Mesorectal Excision in North America: Initial Assessment of a Structured Training Program and the Experience of Delegate Surgeons.
[So] Source:Dis Colon Rectum;60(10):1023-1031, 2017 Oct.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Transanal total mesorectal excision is a new approach to curative-intent rectal cancer surgery. Training and surgeon experience with this approach has not been assessed previously in America. OBJECTIVE: The purpose of this study was to characterize a structured training program and to determine the experience of delegate surgeons. DESIGN: Data were assimilated from an anonymous, online survey delivered to attendees on course completion. Data on surgeon performance during hands-on cadaveric dissection were collected prospectively. SETTINGS: This study was conducted at a single tertiary colorectal surgery referral center, and cadaveric hands-on training was conducted at a specialized surgeon education center. MAIN OUTCOME MEASURES: The main outcome measurement was the use of the course and surgeon experience posttraining. RESULTS: During a 12-month period, eight 2-day transanal total mesorectal excision courses were conducted. Eighty-one colorectal surgeons successfully completed the course. During cadaveric dissection, 71% achieved a complete (Quirke 3) specimen; 26% were near complete (Quirke 2), and 3% were incomplete (Quirke 1). A total of 9.1% demonstrated dissection in the incorrect plane, whereas 4.5% created major injury to the rectum or surrounding structures, excluding the prostate. Thirty eight (46.9%) of 81 surgeon delegates responded to an online survey. Of survey respondents, 94.6% believed training should be required before performing transanal total mesorectal excision. Posttraining, 94.3% of surgeon delegates planned to use transanal total mesorectal excision for distal-third rectal cancers, 74.3% for middle-third cancers, and 8.6% for proximal-third cancers. The most significant complication reported was urethral injury; 5 were reported by the subset of survey respondents who had performed this operation postcourse. LIMITATIONS: The study was limited by inherent reporting bias, including observer and recall biases. CONCLUSIONS: Although this structured training program for transanal total mesorectal excision was found to be useful by the majority of respondents, the risk of iatrogenic injury after training remains high, suggesting that this training pedagogy alone is insufficient. See Video Abstract at http://links.lww.com/DCR/A335.
[Mh] Termos MeSH primário: Canal Anal
Colectomia
Cirurgia Colorretal/educação
Educação
Neoplasias Retais
Cirurgia Endoscópica Transanal
[Mh] Termos MeSH secundário: Canal Anal/patologia
Canal Anal/cirurgia
Biópsia/métodos
Competência Clínica/normas
Colectomia/efeitos adversos
Colectomia/educação
Colectomia/métodos
Cirurgia Colorretal/métodos
Educação/métodos
Educação/normas
Avaliação Educacional/métodos
Florida
Seres Humanos
Melhoria de Qualidade
Neoplasias Retais/patologia
Neoplasias Retais/cirurgia
Desenvolvimento de Pessoal/métodos
Cirurgia Endoscópica Transanal/efeitos adversos
Cirurgia Endoscópica Transanal/educação
Cirurgia Endoscópica Transanal/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171105
[Lr] Data última revisão:
171105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170912
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000823


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[PMID]:28682974
[Au] Autor:Uematsu D; Akiyama G; Sugihara T; Magishi A; Ono K; Yamaguchi T; Sano T
[Ad] Endereço:1 Department of Colorectal Surgery, Saku Central Hospital Advanced Care Center, Nakagomi, Saku-City, Nagano, Japan 2 Department of Surgery, Mimihara Central Hospital, Oosak, Japan 3 Department of Surgery, Saitama Cooperative Hospital, Saitama, Japan.
[Ti] Título:Complete Transanal Total Mesorectal Excision for Lower Rectal Cancer.
[So] Source:Dis Colon Rectum;60(8):872-873, 2017 Aug.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Mesentério/cirurgia
Neoplasias Retais/cirurgia
Cirurgia Endoscópica Transanal/métodos
[Mh] Termos MeSH secundário: Procedimentos Cirúrgicos do Sistema Digestório/métodos
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000855


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[PMID]:28594726
[Au] Autor:Gomes da Silva R; Hanan B; Fonseca LM
[Ad] Endereço:1 Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil 2 Serviço de Coloproctologia, Hospital Mater Dei Contorno, Belo Horizonte, Minas Gerais, Brazil.
[Ti] Título:Treatment of Anastomotic Stricture of a Handsewn Coloanal Anastomosis With Transanal Approach.
[So] Source:Dis Colon Rectum;60(7):755, 2017 Jul.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Adenocarcinoma
Canal Anal/cirurgia
Colectomia
Colo/cirurgia
Neoplasias Retais
Reoperação/métodos
Cirurgia Endoscópica Transanal/métodos
[Mh] Termos MeSH secundário: Adenocarcinoma/patologia
Adenocarcinoma/cirurgia
Anastomose Cirúrgica/efeitos adversos
Anastomose Cirúrgica/métodos
Colectomia/efeitos adversos
Colectomia/métodos
Constrição Patológica/diagnóstico
Constrição Patológica/etiologia
Constrição Patológica/cirurgia
Seres Humanos
Masculino
Meia-Idade
Neoplasias Retais/patologia
Neoplasias Retais/cirurgia
Terapia de Salvação/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170915
[Lr] Data última revisão:
170915
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000775


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[PMID]:28522789
[Au] Autor:Bharathi RS
[Ad] Endereço:Armed Forces Medical College, Department of Surgery, Pune, India.
[Ti] Título:Efficacy of camera sleeve in conveyance of conduits.
[So] Source:Pol Przegl Chir;89(1):76-83, 2017 Feb 28.
[Is] ISSN:2299-2847
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Esophageal substitutes need conveyance from the abdomen into the neck for restoration of alimentary continuity. Reports suggest that the use of plastic camera sleeve may prove advantageous in restoring conveyance. This study aims to evaluate the practicability of this approach, specifically, in laparoscopy-assisted surgeries. METHODS: The efficacy of camera sleeve in conduit transposition was prospectively evaluated over 2 years. The following parameters were assessed: success/failure; time taken; blood loss; adequacy of length of the conduit delivered into the neck; conduit orientation; ease of procedure through different routes; conduit damage; complications; and drawbacks. RESULTS: The technique was used in 25 consecutive patients. Two ileo-colonic, 13 gastric, and 10 colonic conduits were transposed. Posterior mediastinal, retro-sternal, and ante-sternal routes were used in 15, 8, and 2 cases, respectively. There were no failures. The technique was easy to adopt. It added < 10 minutes to the procedure. It entailed no additional blood loss. Adequate length of the conduit was transposed into the neck, atraumatically. Conduits maintained their orientation without effort. Although no complications per se were associated with its use, extra conduit length became transposed into the neck, twice, necessitating its trimming/adjustment. In one case, traction suture became avulsed from the conduit, midway in the tunnel. This could easily be rectified by pulling out the sleeve from the neck, which brought up the conduit along with it, as desired. CONCLUSIONS: Use of camera sleeve proves efficacious in interposition of esophageal substitutes.
[Mh] Termos MeSH primário: Anastomose Cirúrgica/métodos
Colectomia/métodos
Doenças do Colo/cirurgia
Gastroenterostomia/métodos
Cirurgia Endoscópica Transanal/métodos
[Mh] Termos MeSH secundário: Procedimentos Cirúrgicos do Sistema Digestório
Feminino
Seres Humanos
Masculino
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170520
[St] Status:MEDLINE
[do] DOI:10.5604/01.3001.0009.6010


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[PMID]:28501248
[Au] Autor:Young DO; Kumar AS
[Ad] Endereço:Colorectal Surgery Program, Section of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, 1100 9th Avenue Seattle, WA 98101, USA.
[Ti] Título:Local Excision of Rectal Cancer.
[So] Source:Surg Clin North Am;97(3):573-585, 2017 Jun.
[Is] ISSN:1558-3171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Local excision (LE) of early-stage rectal cancer avoids the morbidity associated with radical surgery but has historically been associated with inferior oncologic outcomes. Newer techniques, including transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS), have been developed to improve the quality of LE and extend the benefits of LE to tumors in the more proximal rectum. This article provides an overview of conventional LE, TEM, and TAMIS techniques, including indications for their use and pertinent literature on their associated outcomes for rectal cancer.
[Mh] Termos MeSH primário: Cirurgia Colorretal/métodos
Procedimentos Cirúrgicos Minimamente Invasivos
Neoplasias Retais/cirurgia
Cirurgia Endoscópica Transanal
[Mh] Termos MeSH secundário: Seres Humanos
Terapia Neoadjuvante
Neoplasias Retais/terapia
Reto/cirurgia
Microcirurgia Endoscópica Transanal
Cirurgia Endoscópica Transanal/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170515
[St] Status:MEDLINE



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