Home > Riviste > Minerva Chirurgica > Fascicoli precedenti > Articles online first > Minerva Chirurgica 2021 Jan 12

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

 

Minerva Chirurgica 2021 Jan 12

DOI: 10.23736/S0026-4733.20.08405-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Management of intra- and post-operative complications during TEM/TAMIS procedures. A systematic review

Xavier SERRA-ARACIL , Jesus BADIA-CLOSA, Anna PALLISERA-LLOVERAS, Laura MORA-LOPEZ, Sheila SERRA-PLA, Albert GARCIA-NALDA, Salvador NAVARRO-SOTO

Colorectal Unit, Department of General and Digestive Surgery, Parc Taulí University Hospital, Universitat Autònoma de Barcelona (UAB), Sabadell, Barcelona, Spain


PDF


INTRODUCTION: Transanal endoscopic microsurgery (TEM) is a safe procedure and the rates of intra- and post-operative complications are low. The information in the literature on the management of these complications is limited, and so their importance may be either under- or overestimated (which may in turn lead to under- or overtreatment). The present article reviews the most relevant series of TEM procedures and their complications and describes various approaches to their management.
EVIDENCE ACQUISITION: A systematic review of the literature, including TEM series of more than 150 cases each. We analyzed the population characteristics, surgical variables and intraoperative and postoperative complications.
EVIDENCE GATHERING: A total of 1043 records were found. After review, 1031 were excluded. The review therefore includes 12 independent cohorts of TEM procedures with a total of 4395 patients. The rate of perforation into the peritoneal cavity was 5.1%, and conversion to abdominal approach was required in 0.8% of cases. The most frequent complications were acute urinary retention (AUR, 4.9%) and rectal bleeding (2.2%). Less common complications included abscesses (0.99%) and rectovaginal fistula (0.62%). Mortality rates were low, with a mean value of 0.29%.
CONCLUSIONS: Awareness and knowledge of TEM complications and their management can play an important role in their treatment and patient safety. Here, we present a review of the most important TEM series and their complication rates and describe various approaches to their management.


KEY WORDS: Transanal endoscopic microsurgery; TEM; TEO; Minimally invasive surgery; Morbidity; Morbidity management

inizio pagina