Notes total mesorectal excision (TME) for patients with rectal neoplasia
Background Natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy are emerging, minimally invasive techniques. Total mesorectal excision (TME), the gold standard treatment for patients with resectable distal rectal tumors, is usually performed in an “up-to-down” appr...
محفوظ في:
| المؤلف الرئيسي: | |
|---|---|
| مؤلفون آخرون: | , , , , , |
| التنسيق: | article |
| منشور في: |
2014
|
| الوصول للمادة أونلاين: | http://hdl.handle.net/10725/2636 http://dx.doi.org/10.1007/s00464-014-3573-z http://link.springer.com/article/10.1007/s00464-014-3573-z |
| الوسوم: |
إضافة وسم
لا توجد وسوم, كن أول من يضع وسما على هذه التسجيلة!
|
| _version_ | 1864513459009355776 |
|---|---|
| author | Chouillard, E. |
| author2 | Khoury, G. Chahine, E. Vincent-Bonnet, B. G|umbs, A. Azoulay, D. Abdalla, Eddie |
| author2_role | author author author author author author |
| author_facet | Chouillard, E. Khoury, G. Chahine, E. Vincent-Bonnet, B. G|umbs, A. Azoulay, D. Abdalla, Eddie |
| author_role | author |
| dc.creator.none.fl_str_mv | Chouillard, E. Khoury, G. Chahine, E. Vincent-Bonnet, B. G|umbs, A. Azoulay, D. Abdalla, Eddie |
| dc.date.none.fl_str_mv | 2014 2015-11-20T07:20:44Z 2015-11-20T07:20:44Z 2017-10-12 |
| dc.identifier.none.fl_str_mv | 0930-2794 http://hdl.handle.net/10725/2636 http://dx.doi.org/10.1007/s00464-014-3573-z Chouillard, E., Chahine, E., Khoury, G., Vinson-Bonnet, B., Gumbs, A., Azoulay, D., & Abdalla, E. (2014). NOTES total mesorectal excision (TME) for patients with rectal neoplasia: a preliminary experience. Surgical endoscopy, 28(11), 3150-3157. http://link.springer.com/article/10.1007/s00464-014-3573-z |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Surgical Endoscopy |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Notes total mesorectal excision (TME) for patients with rectal neoplasia A preliminary experience |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Background Natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy are emerging, minimally invasive techniques. Total mesorectal excision (TME), the gold standard treatment for patients with resectable distal rectal tumors, is usually performed in an “up-to-down” approach, either laparoscopically or via open techniques. A transanal, “down-to-up” TME has already been reported. Our NOTES variant of TME (NOTESTME) is based on a transperineal approach without any form of abdominal assistance. The aim was to reduce further the invasiveness of the procedure while optimizing the anatomical definition of the distal mesorectum. This approach may lead to reduced postoperative pain, decreased hernia formation and improved cosmesis when compared to standard laparoscopy. Methods NOTESTME was attempted in 16 patients with distal rectal neoplasia (i.e., distal edge of the tumor lower than the pouch of Douglas, between 0 and 12 cm from the dentate line). Additional inclusion criteria consisted of an ASA status ≤III and the absence of previous abdominal surgery. Results NOTESTME was completed in all patients. Additional abdominal, single-incision laparoscopic assistance was required in 6 (38 %) patients. Mean operative time was 265 min (range 155–440 min). The morbidity rate was 18.8 % (two small bowel obstructions and one pelvic abscess), requiring re-operation in each case. No leaks occurred, and the mortality rate at 30 and 90 days was 0 %. Resection margins were negative in all patients. A median of 17 nodes (range 12–81) was retrieved per specimen. Mean length of hospital stay was 10 days (range 4–29 days). Patients were followed for an average of 7 months (range 3–23 months). Conclusion NOTESTME was feasible and safe in this series of patients with mid- or low rectal tumors. The short-term mortality and morbidity rates are acceptable, with no apparent compromise in the oncological quality of the resection. Larger, randomized controlled trials with long-term follow-up are warranted. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_04c2022a060481c95d4e3f61c32bcd31 |
| identifier_str_mv | 0930-2794 Chouillard, E., Chahine, E., Khoury, G., Vinson-Bonnet, B., Gumbs, A., Azoulay, D., & Abdalla, E. (2014). NOTES total mesorectal excision (TME) for patients with rectal neoplasia: a preliminary experience. Surgical endoscopy, 28(11), 3150-3157. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/2636 |
| publishDate | 2014 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Notes total mesorectal excision (TME) for patients with rectal neoplasiaA preliminary experienceChouillard, E.Khoury, G.Chahine, E.Vincent-Bonnet, B.G|umbs, A.Azoulay, D.Abdalla, EddieBackground Natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy are emerging, minimally invasive techniques. Total mesorectal excision (TME), the gold standard treatment for patients with resectable distal rectal tumors, is usually performed in an “up-to-down” approach, either laparoscopically or via open techniques. A transanal, “down-to-up” TME has already been reported. Our NOTES variant of TME (NOTESTME) is based on a transperineal approach without any form of abdominal assistance. The aim was to reduce further the invasiveness of the procedure while optimizing the anatomical definition of the distal mesorectum. This approach may lead to reduced postoperative pain, decreased hernia formation and improved cosmesis when compared to standard laparoscopy. Methods NOTESTME was attempted in 16 patients with distal rectal neoplasia (i.e., distal edge of the tumor lower than the pouch of Douglas, between 0 and 12 cm from the dentate line). Additional inclusion criteria consisted of an ASA status ≤III and the absence of previous abdominal surgery. Results NOTESTME was completed in all patients. Additional abdominal, single-incision laparoscopic assistance was required in 6 (38 %) patients. Mean operative time was 265 min (range 155–440 min). The morbidity rate was 18.8 % (two small bowel obstructions and one pelvic abscess), requiring re-operation in each case. No leaks occurred, and the mortality rate at 30 and 90 days was 0 %. Resection margins were negative in all patients. A median of 17 nodes (range 12–81) was retrieved per specimen. Mean length of hospital stay was 10 days (range 4–29 days). Patients were followed for an average of 7 months (range 3–23 months). Conclusion NOTESTME was feasible and safe in this series of patients with mid- or low rectal tumors. The short-term mortality and morbidity rates are acceptable, with no apparent compromise in the oncological quality of the resection. Larger, randomized controlled trials with long-term follow-up are warranted.PublishedN/A2015-11-20T07:20:44Z2015-11-20T07:20:44Z20142017-10-12Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0930-2794http://hdl.handle.net/10725/2636http://dx.doi.org/10.1007/s00464-014-3573-zChouillard, E., Chahine, E., Khoury, G., Vinson-Bonnet, B., Gumbs, A., Azoulay, D., & Abdalla, E. (2014). NOTES total mesorectal excision (TME) for patients with rectal neoplasia: a preliminary experience. Surgical endoscopy, 28(11), 3150-3157.http://link.springer.com/article/10.1007/s00464-014-3573-zenSurgical Endoscopyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/26362021-03-19T09:59:49Z |
| spellingShingle | Notes total mesorectal excision (TME) for patients with rectal neoplasia Chouillard, E. |
| status_str | publishedVersion |
| title | Notes total mesorectal excision (TME) for patients with rectal neoplasia |
| title_full | Notes total mesorectal excision (TME) for patients with rectal neoplasia |
| title_fullStr | Notes total mesorectal excision (TME) for patients with rectal neoplasia |
| title_full_unstemmed | Notes total mesorectal excision (TME) for patients with rectal neoplasia |
| title_short | Notes total mesorectal excision (TME) for patients with rectal neoplasia |
| title_sort | Notes total mesorectal excision (TME) for patients with rectal neoplasia |
| url | http://hdl.handle.net/10725/2636 http://dx.doi.org/10.1007/s00464-014-3573-z http://link.springer.com/article/10.1007/s00464-014-3573-z |