Potential of Endoscopic Microsurgery

Czech version

Authors: L. Starý; I. Klementa; P. Zbořil; P. Skalický; I. Švach; Č. Neoral
Authors‘ workplace: I. chirurgická klinika LF UP a FN Olomouc, přednosta: doc. MUDr. Č. Neoral, CSc.
Published in: Rozhl. Chir., 2010, roč. 89, č. 12, s. 770-773.
Category: Monothematic special - Original

Overview

Aim:
Evaluate our more than seven year experience with transanal endoscopic microsurgical technique (TEM).

Materials and methods:
The authors prospectively evaluated a set of 393 patients who were operated using the TEM method.

Results:
Out of 393 patients, 371 (94%) were indicated for the procedure for rectal tumor; 82 of these tumors were malignant. Nine patients underwent a rectoplasty for rectal stenosis, and in five patients drainage of a perirectal fluid collection was performed. Four patients underwent the surgical procedure for bleeding from the rectal tumor and in four patients an ulcerous lesion was removed from the rectum. Complications in the set of patients with malignant or benign tumors of the rectum occurred in 21 (6%) cases. Ten patients had bleeding, three patients underwent surgical revision for peritonitis with dehiscence of the intraabdominal bowel suture after transmural resection, periproctal abscess occurred in five patients, rectovaginal fistula was observed in three patients. There was no postoperative mortality.

Conclusion:
Transanal endoscopic microsurgery has become a standard therapeutic procedure. In oncosurgery, for early stages of rectal tumors, it is an equivalent alternative to conventional surgery with the advantages of minimal morbidity, mortality, postoperative complications, and sexual and urological dysfunctions. This, however, is only true when indication criteria are strictly adhered to and principles of resection radicality are maintained.

Key words:
transanal endoscopic microsurgery – operating rectoscope – local therapy of rectal tumors

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