Transanal endoscopic microsurgery

    Research output: Contribution to journalArticle

    6 Citations (Scopus)

    Abstract

    Transanal endoscopic microsurgery (TEM) is a minimally invasive surgical techniquethat was developed more than two decades ago to manage distal colorectal neoplasias.The aimof the current study was to present a prospective review of 7 years of experiencein using this equipment. All patients undergoing TEM between 1999 and 2007 wereprospectively evaluated. Patients underwent regular endoscopic follow up. Cumulativeincidence probability analysis was used to calculate rates of recurrence. The studyinvolved 232 patients, median age 68 years (interquartile range (IQR), 37–90). Themedian neoplasia area was 12 cm2 (IQR, 6–25 cm2) and the median height above theanal verge was 9 cm (IQR, 3–17 cm). Histology indicated 128 adenomas, 52 carcinomasin situ, and 52 adenocarcinomas. The median postoperative stay was 1 day (IQR,1–3 days). There was one (0.5%) unplanned return to theatre and no postoperativedeaths. Sixteen patients (6.9%) underwent more radical surgical procedures followingthe identification of carcinoma in the resected specimen. During a median follow up of4.2 years (IQR, 2.6–6.2 years), the 5-year cumulative incidence for local recurrence forbenign pathology was 3.1% (95% confidence interval (CI): 1.2–6.7%, n = 180) and forcancers managed primarily by TEM excision it was 8.5% (95%CI: 1.4–23.9%, n = 36).TEM is an excellent treatment modality for benign rectal neoplasias of any size, and inany location. TEM is an oncologically inferior treatment for rectal cancer, however,when compared to more radical treatments. Its principal advantage in this setting is thatit is associated with relatively minimal morbidity and mortality.
    Original languageEnglish
    Pages (from-to)275-280
    JournalANZ Journal of Surgery
    Volume79
    Issue number4
    DOIs
    Publication statusPublished - 2009

    Fingerprint

    Confidence Intervals
    Recurrence
    Neoplasms
    Rectal Neoplasms
    Adenoma
    Histology
    Adenocarcinoma
    Therapeutics
    Transanal Endoscopic Microsurgery
    Pathology
    Morbidity
    Carcinoma
    Equipment and Supplies
    Mortality
    Incidence

    Cite this

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    title = "Transanal endoscopic microsurgery",
    abstract = "Transanal endoscopic microsurgery (TEM) is a minimally invasive surgical techniquethat was developed more than two decades ago to manage distal colorectal neoplasias.The aimof the current study was to present a prospective review of 7 years of experiencein using this equipment. All patients undergoing TEM between 1999 and 2007 wereprospectively evaluated. Patients underwent regular endoscopic follow up. Cumulativeincidence probability analysis was used to calculate rates of recurrence. The studyinvolved 232 patients, median age 68 years (interquartile range (IQR), 37–90). Themedian neoplasia area was 12 cm2 (IQR, 6–25 cm2) and the median height above theanal verge was 9 cm (IQR, 3–17 cm). Histology indicated 128 adenomas, 52 carcinomasin situ, and 52 adenocarcinomas. The median postoperative stay was 1 day (IQR,1–3 days). There was one (0.5{\%}) unplanned return to theatre and no postoperativedeaths. Sixteen patients (6.9{\%}) underwent more radical surgical procedures followingthe identification of carcinoma in the resected specimen. During a median follow up of4.2 years (IQR, 2.6–6.2 years), the 5-year cumulative incidence for local recurrence forbenign pathology was 3.1{\%} (95{\%} confidence interval (CI): 1.2–6.7{\%}, n = 180) and forcancers managed primarily by TEM excision it was 8.5{\%} (95{\%}CI: 1.4–23.9{\%}, n = 36).TEM is an excellent treatment modality for benign rectal neoplasias of any size, and inany location. TEM is an oncologically inferior treatment for rectal cancer, however,when compared to more radical treatments. Its principal advantage in this setting is thatit is associated with relatively minimal morbidity and mortality.",
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    Transanal endoscopic microsurgery. / Platell, Cameron.

    In: ANZ Journal of Surgery, Vol. 79, No. 4, 2009, p. 275-280.

    Research output: Contribution to journalArticle

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    N2 - Transanal endoscopic microsurgery (TEM) is a minimally invasive surgical techniquethat was developed more than two decades ago to manage distal colorectal neoplasias.The aimof the current study was to present a prospective review of 7 years of experiencein using this equipment. All patients undergoing TEM between 1999 and 2007 wereprospectively evaluated. Patients underwent regular endoscopic follow up. Cumulativeincidence probability analysis was used to calculate rates of recurrence. The studyinvolved 232 patients, median age 68 years (interquartile range (IQR), 37–90). Themedian neoplasia area was 12 cm2 (IQR, 6–25 cm2) and the median height above theanal verge was 9 cm (IQR, 3–17 cm). Histology indicated 128 adenomas, 52 carcinomasin situ, and 52 adenocarcinomas. The median postoperative stay was 1 day (IQR,1–3 days). There was one (0.5%) unplanned return to theatre and no postoperativedeaths. Sixteen patients (6.9%) underwent more radical surgical procedures followingthe identification of carcinoma in the resected specimen. During a median follow up of4.2 years (IQR, 2.6–6.2 years), the 5-year cumulative incidence for local recurrence forbenign pathology was 3.1% (95% confidence interval (CI): 1.2–6.7%, n = 180) and forcancers managed primarily by TEM excision it was 8.5% (95%CI: 1.4–23.9%, n = 36).TEM is an excellent treatment modality for benign rectal neoplasias of any size, and inany location. TEM is an oncologically inferior treatment for rectal cancer, however,when compared to more radical treatments. Its principal advantage in this setting is thatit is associated with relatively minimal morbidity and mortality.

    AB - Transanal endoscopic microsurgery (TEM) is a minimally invasive surgical techniquethat was developed more than two decades ago to manage distal colorectal neoplasias.The aimof the current study was to present a prospective review of 7 years of experiencein using this equipment. All patients undergoing TEM between 1999 and 2007 wereprospectively evaluated. Patients underwent regular endoscopic follow up. Cumulativeincidence probability analysis was used to calculate rates of recurrence. The studyinvolved 232 patients, median age 68 years (interquartile range (IQR), 37–90). Themedian neoplasia area was 12 cm2 (IQR, 6–25 cm2) and the median height above theanal verge was 9 cm (IQR, 3–17 cm). Histology indicated 128 adenomas, 52 carcinomasin situ, and 52 adenocarcinomas. The median postoperative stay was 1 day (IQR,1–3 days). There was one (0.5%) unplanned return to theatre and no postoperativedeaths. Sixteen patients (6.9%) underwent more radical surgical procedures followingthe identification of carcinoma in the resected specimen. During a median follow up of4.2 years (IQR, 2.6–6.2 years), the 5-year cumulative incidence for local recurrence forbenign pathology was 3.1% (95% confidence interval (CI): 1.2–6.7%, n = 180) and forcancers managed primarily by TEM excision it was 8.5% (95%CI: 1.4–23.9%, n = 36).TEM is an excellent treatment modality for benign rectal neoplasias of any size, and inany location. TEM is an oncologically inferior treatment for rectal cancer, however,when compared to more radical treatments. Its principal advantage in this setting is thatit is associated with relatively minimal morbidity and mortality.

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