Transanal Endoscopic Microsurgery: Endoscopy Assisted Treatment of Colorectal Anastomotic Stenosis.

Transanal endoscopic microsurgery (TEM) is a type of natural orifice transluminal endoscopic surgery, developed for rectal tumors and used also to treat other rectal diseases. Anastomotic complications after colorectal surgery, including stenosis, represent a challenging problem. We present the case of a 36-year-old woman with a diagnosis of Hirschsprung disease that was submitted to a modified Duhamel operation.

Quality of life in patients with loco-regional rectal cancer after ELRR by TEM versus VLS TME after nChRT: long-term results.

Background: Endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) may be an alternative treatment option to Laparoscopic total mesorectal excision (LTME), in selected patients with N0 rectal cancer. Post-operative quality of life (QoL) evaluation is an important parameter of outcomes related to high percentage of functional sequelae. We reported, in a previous paper, the short and medium term results of QoL in patients who underwent ELRR or LTME.

Anal function after endoluminal locoregional resection by transanal endoscopic microsurgery and radiotherapy for rectal cancer.

Aim: In patients with rectal cancer, surgery and chemoradiotherapy may affect anal sphincter function. Few studies have evaluated anorectal function after neoadjuvant chemoradiotherapy (n-CRT) and/or transanal endoscopic microsurgery (TEM). The aim of this study was to evaluate the effects of n-CRT and TEM on anorectal function.

A 23 year experience with laparoscopic common bile duct exploration.

Background: Laparoscopic common bile duct exploration (LCBDE) during laparoscopic cholecystectomy (LC) is as effective as two-stage endo-laparoscopic treatment, but with shorter hospital stay, lower cost and recurrent stone rate. Aim of this paper was to report the authors' experience with LCBDE during LC.

Methods: A retrospective analysis of patients who underwent LCBDE for ductal stones was performed.

Endoluminal loco-regional resection by TEM after R1 endoscopic removal or recurrence of rectal tumors.

Purpose: The aim of this study is to evaluate the safety and efficacy of endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) after R1 endoscopic resection or local recurrence of early rectal cancer after operative endoscopy.

Material And Methods: Twenty patients with early rectal cancer were enrolled, including patients with incomplete endoscopic resection, or complete endoscopic resection of a tumor with unfavorable prognostic factors (group A, ten patients), and local recurrence after endoscopic removal (group B, ten patients). At admission, histology after endoscopic polypectomy was: TisR1(4), T1R0G3(1), T1R1(5) in group A, and TisR0(8), T1R0(2) in group B.

Results of Medium Seventeen Years' Follow-Up after Laparoscopic Choledochotomy for Ductal Stones.

Introduction. In a previously published article the authors reported the long-term follow-up results in 138 consecutive patients with gallstones and common bile duct (CBD) stones who underwent laparoscopic transverse choledochotomy (TC) with T-tube biliary drainage and laparoscopic cholecystectomy (LC). Aim of this study is to evaluate the results at up to 23 years of follow-up in the same series.

Management of adrenal incidentaloma by laparoscopic transperitoneal anterior and submesocolic approach.

Purpose: Laparoscopic adrenalectomy (LA) is becoming the main approach for incidentally discovered adrenal masses (adrenal incidentaloma (AI)). The aim of this study was to evaluate the results of LA with a transperitoneal anterior approach for right adrenal lesions and either a transperitoneal anterior or transperitoneal anterior submesocolic approach for the left-sided lesions.

Methods: The study is a retrospective analysis of prospectively collected data.

Treatment of recto-vesical fistula by transanal endoscopic microsurgery approach.

Introduction: Rectovesical Fistula (RVF) is a rare major surgery complication. Despite different techniques have been proposed as yet there is still no standard treatment. Transanal Endoscopic Microsurgery provides a magnified three-dimensional vision and it is less invasive than the traditional surgical procedure used in RVF treatment.

Quality of life in non-early rectal cancer treated by neoadjuvant radio-chemotherapy and endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) versus laparoscopic total mesorectal excision.

Background: In selected patients with N0 rectal cancer, endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) may be an alternative treatment option to laparoscopic total mesorectal excision (LTME). Aim of this study is to evaluate the short- and medium-term quality of life (QoL) from a retrospective analysis of prospectively collected data in patients with iT2-iT3 N0-N+ rectal cancer, who underwent ELRR by TEM or LTME after neoadjuvant radio-chemotherapy (n-RCT).

Methods: Thirty patients with iT2-iT3 rectal cancer who underwent ELRR by TEM (n = 15) or LTME (n = 15) were enrolled in this study.

Endoscopic placement of self-expandable metallic stents for rectovaginal fistula after colorectal resection: a comparison with proximal diverting ileostomy alone.

Background: Self-expandable metal stents can be used to treat patients with rectovaginal fistula after colorectal resection for cancer.

Methods: Fifteen patients with rectovaginal fistula, after colorectal resection for cancer, were treated with endoscopic placement of a self-expandable metal stent. In four patients, a diverting proximal stoma had been performed elsewhere.

Treatment of rectovaginal fistula after colorectal resection with endoscopic stenting: long-term results.

Aim: To treat patients with rectovaginal fistula after anterior resection for cancer using self-expanding metal stents.

Method: Ten patients of mean age of 56.3 years with rectovaginal fistula after colorectal resection for cancer were treated with endoscopic placement of a self-expanding metal stent.

Rare extra-adrenal paraganglioma mimicking a painful Schwannoma: case report.

Introduction: Paragangliomas originate from chromaffin tissue primarily found in the Zuckerkandl body. A 53 years old man, was investigated with abdominal MRI for chronic backache, that had lasted for 2 years.

Case Report: MRI revealed an incidental mass in para-aortic region, at the adrenal lodge, with characteristics of a solid nodular mass, which did not seem to arise from the adrenal gland.

Tricks to decrease the suture line dehiscence rate during endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM).

Background: ELRR by TEM is a valid alternative to TME in selected patients with early low rectal cancer, with similar long-term oncological results and better Quality of Life. The authors' policy is to close the residual defect, with possibly a higher risk of dehiscence from tension on the suture line. Aim is to evaluate if a modified technique may reduce the risk of dehiscence.

On the suitability of Thiel cadavers for natural orifice transluminal endoscopic surgery (NOTES): surgical training, feasibility studies, and anatomical education.

Background: Surgical training in virtual, animal and cadaver models is essential for minimally invasive surgery. Thiel cadavers are suitable for laparoscopy, but there are few data about the use of embalmed (Tutsch method) and slightly embalmed (Thiel method) cadavers in procedures of Natural Orifice Transluminal Endoscopic Surgery (NOTES), which are usually developed and learned on swine models and fresh frozen cadavers. The aim of this study was thus to assess the use of these cadavers for NOTES approaches.

Transanal ileoproctostomy is feasible in human cadavers.

Aim: An ileorectal bypass performed entirely through a transanal route has recently been described in an animal model. The present study aimed to demonstrate its technical feasibility in four human cadavers.

Method: A transanal endoscopic microsurgery (TEM) device and endoscopic instruments were used.

Laparoscopic transperitoneal anterior adrenalectomy in pheochromocytoma: experience in 62 patients.

Background: Aim was to evaluate the results in 62 patients undergoing laparoscopic adrenalectomy (LA) for the treatment of pheochromocytoma (PHE), with a transperitoneal anterior approach for lesions on the right side, and with a transperitoneal anterior submesocolic approach in case of left-sided lesions.

Methods: Sixty-two patients underwent LA for the treatment of PHE at two centers in Rome and Ancona (Italy). Two patients had bilateral lesions, for a total of 64 adrenalectomies.

Treatment of anastomotic stenosis and leakage after colorectal resection for cancer with self-expandable metal stents.

Background: Self-expandable metallic stents can be used to treat patients with symptomatic anastomotic complications after colorectal resection.

Methods: Twenty patients with symptomatic anastomotic stricture after colorectal resection were treated with endoscopic placement of a self-expandable metal stent. Ten patients had "simple" anastomotic stricture.

Self-expandable metal stents in the treatment of benign anastomotic stricture after rectal resection for cancer.

Aim: To evaluate the use of self-expandable metallic stents to treat patients with symptomatic benign anastomotic stricture after colorectal resection.

Method: Ten patients with a benign symptomatic anastomotic stricture after colorectal resection were treated with endoscopic placement of a self-expandable metal stent.

Results: The stent was placed successfully in all 10 patients without any major morbidity.

Quality-of-life impairment after endoluminal locoregional resection and laparoscopic total mesorectal excision.

Background: For selected patients with rectal cancer, endoluminal locoregional resection (ELRR) by transanal endoscopic microsurgery (TEM) may be an alternative treatment option to laparoscopic total mesorectal excision (LTME). Few data are available on quality of life (QoL) after LTME and TEM. This study aimed to compare short- and medium-term QoL for T1 rectal cancer patients undergoing LTME or ELRR by TEM.

Breast myofibroblastoma in a young woman: a case report.

Myofibroblastoma (MFB) is an uncommon benign mesenchymal tumor that may arise in several organs and tissue. Although most of reported cases were located in the breast, it is extremely rare, representing less than 1% of breast tumor. MFB has predominantly seen in elderly men, but some cases have been described in menopausal women.

Transanal endoscopic microsurgery for rectal tumors: an option to radical surgery?

Aim: We present our experience in the treatment of rectal adenomas and selected cases of distal rectal cancer without evidence of nodal or distant metastasis (N0-M0) managed by transanal endoscopic microsurgery (TEM). This study examines our experience evaluating surgical morbidity, mortality and oncological outcome.

Methods: Eight hundred ten patients with rectal lesions (462 adenomas, 115 T1, 130 T2 and 103 T3) were enrolled.

Self-expanding metal stents for treatment of anastomotic complications after colorectal resection.

Self-expanding metal stents (SEMS) can be used to treat patients with symptomatic anastomotic complications after colorectal resection. In the present case series, 16 patients with symptomatic anastomotic stricture after colorectal resection were treated with endoscopic placement of SEMS. Seven patients had a "simple" anastomotic stricture and nine patients had a fistula associated with the stricture.