Home > Journals > Minerva Chirurgica > Past Issues > Minerva Chirurgica 2016 December;71(6) > Minerva Chirurgica 2016 December;71(6):360-4

CURRENT ISSUE
 

ARTICLE TOOLS

Reprints
Cite this article as

MINERVA CHIRURGICA

A Journal on Surgery


Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,115


eTOC

 

ORIGINAL ARTICLES  


Minerva Chirurgica 2016 December;71(6):360-4

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Transanal endoscopic microsurgery in the treatment of large rectal adenomas

Mario GUERRIERI, Monica ORTENZI, Giovanni LEZOCHE, Stefano MANCINI, Roberto GHISELLI

Surgery Clinic, Marche Polytechnic University, Ancona, Italy


PDF  


BACKGROUND: Transanal endoscopic microsurgery (TEM) is a minimally invasive technique allowing to excise large rectal adenomas by local approach. This study shows the feasibility and results of a long term experience of TEM applied in this field.
METHODS: A retrospective investigation was performed in patients affected by rectal adenomas (5-11 cm in diameter) who had undergone transanal endoscopic microsurgery from 1992 to 2015. A series of 207 patients met the inclusion criteria and were analyzed for characteristics, intraoperative and postoperative results and long-term follow-up.
RESULTS: Median age was 71 years (52-83 years). Of the 207 total patients, 77 were women (37.2%) and 130 men (62.8%). Median distance from the anal verge was 8 cm (4-20 cm). Median size was 6 cm, with lesion ranging from 5 to 11 cm in diameter. Median operative time was 57 minutes (42-90 minutes). We observed 17 (8.2%) minor complications and 2 (0.9%) major complication according to the Clavien-Dindo classification. We did not observe any intraoperative or post-operative mortality. Histological examination showed preoperative undiagnosed cancer in 8 (3.8%) cases in which the pathologist revealed adenocarcinoma staged as T1 Sm1 according to the Kikuchi classification. The median follow-up was 115 months (12-288 months). Six recurrences (2.9%), we observed with a median time for recurrence of 14 months.
CONCLUSIONS: TEM provides excellent oncological outcomes in the treatment of large benign rectal lesions, ensuring a minimal risk of resection margin infiltration at pathological examination, and is associated with low risk of complications.

top of page

Publication History

Cite this article as

Guerrieri M, Ortenzi M, Lezoche G, Mancini S, Ghiselli R. Transanal endoscopic microsurgery in the treatment of large rectal adenomas. Minerva Chir 2016 December;71(6):360-4. 

Corresponding author e-mail

monica.ortenzi@gmail.com