Pushing the limits of local excision for rectal cancer: transanal minimally invasive surgery for an upper rectal/rectosigmoid lesion.

Background: Transanal minimally invasive surgery (TAMIS) is an evolving technique for the local excision of early rectal cancers,1 particularly for mid-rectal lesions. The approach to upper rectal lesions is significantly more challenging and prone to complications. We demonstrate TAMIS for an upper rectal/rectosigmoid lesion, with transanal repair of an intraoperative rectal/rectosigmoid perforation.

Necrotizing soft tissue infections.

Necrotizing soft tissue infections (NSTIs) are infrequent yet highly lethal infections, and a high index of suspicion is required for early diagnosis. Diagnosing NSTIs early can be challenging, and knowledge of the available tools is essential to provide appropriate treatment. The mainstay of treatment is early and complete surgical debridement combined with antimicrobial therapy, close monitoring with further debridement as needed, and physiologic support.