Sphincter-saving surgery in patients with rectal cancer treated by radiotherapy and transanal endoscopic microsurgery: 10 years' experience.

Background/aims: Transanal endoscopic microsurgery (TEM) is a technique which allows minimally invasive full-thickness local excision of rectal tumours with perirectal fat dissection.

Methods: Our study examined a group of 137 selected patients with rectal cancer treated by TEM excision combined with preoperative radiotherapy. The definitive histology was as follows: 37 patients with pT1 stage rectal cancer (27%), 59 with pT2 (43%) and 23 with pT3 (17%).

Type a syndrome of insulin resistance: anterior chamber anomalies of the eye and effects of insulin-like growth factor-I on the retina.

Background: The purpose of this work was to describe the anterior chamber and iris anomalies as well as to evaluate the effects of recombinant human insulin-like growth factor-I (rhIGF-I) on the retinal vessels in 2 diabetic patients with type A syndrome of insulin resistance, a rare condition associated with acanthosis nigricans.

Methods: Ophthalmologic examinations, including photographs and fluorescein angiograms, were performed before, and 2 and 4 weeks after starting subcutaneous rhIGF-I treatment, and 3 months after withdrawal of rhIGF-I treatment.

Results: Both patients had goniodysgenesis with mild elevation of the intraocular pressure.

Local excision of rectal cancer by transanal endoscopic microsurgery (TEM) combined with radiotherapy: new concept of therapeutic approach.

Transanal endoscopic microsurgery (TEM), associated with preoperative radiotherapy in selected groups, allows minimally invasive full thickness local excision of rectal tumors with perirectal fat dissection. In our experience, 95 patients with extraperitoneal rectal carcinoma underwent TEM resection for T1 (21 cases), T2 (48 cases) and T3 (15 cases) lesions. In eleven patients the pathologist did not find cancer cells in the specimen (pT0) after full dose of radiotherapy and TEM.

Laparoscopic adrenalectomy by the anterior transperitoneal approach: results of 108 operations in unselected cases.

Background: The feasibility, safety, and results of 108 laparoscopic anterior transperitoneal adrenalectomies (six bilateral) were evaluated in a series of 105 patients. Three patients with a preoperative diagnosis of primary adrenal carcinoma were excluded from the study.

Methods: A total of 102 patients were included in the study based on exhaustive endocrinological and imaging assessment.

[Echography in minimally invasive surgery].

Thanks to the great development of laparoscopic surgery and his continuous technical evolution, echography plays more and more important role in the pre- and intraoperative diagnosis. In the hepato-pancreatic pathology the use of the laparoscopic echography reduces clearly the role of laparotomic exploration. In laparoscopic surgery of rectal-colon, the echography is more specific and sensitive in compared with pre-operative MR and CT to individualize liver metastasis, to locate them.