Abstract
Background
We used video-assisted gasless transanal endoscopic microsurgery (TEM) to evaluate 12 consecutive patients for carcinoid tumor with pathologically typical features in the proximal rectum. The study parameters included feasibility, results and final outcome.
Methods
A scope with an optical angle of 25° and a 7-mm diameter was used for TEM. The carcinoid tumor was resected in full thickness. Primary closure was accomplished using a running suture of 3-0 braided absorbable suture.
Results
The tumor in these patients was <15 mm in diameter. It was localized within the submucosal layer on the oral side from the peritoneal reflection and unreachable via Park’s transanal approach. The mean duration of the operation was 63 min. The postoperative course in all patients was free from significant complications, and all patients were discharged within 1 week. None of the patients had postoperative pain or required sedatives.
Conclusion
Video-assisted gasless TEM is a simple and minimally invasive procedure to treat benign carcinoid tumors in the proximal rectum.
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References
Araki Y, Isomoto H, Shirouzu K (1992) A study on polyethylene glycol electrolyte lavage solution and sodium picosulfate combined pretreatment method for colonoscopy. Kurume Med J 39: 117–121
Araki Y, Shirouzu K, Ogata Y (1993) Therapeutic rectoscopy for the rectal tumors. Kurume Med J 404: 1–5
Buess G, Hutterer F, Theiss R (1984) A system for a transanal endoscopic rectum operation. Chirurg 55: 677–680
Hasegawa S, Iwashita A, Futami K (1997) A clinicopathological study on rectal carcinoid with special reference to immunohistochemical factors of malignant potential. J Jpn Soc Coloproctol 50: 163–176
Jetmore AB, Ray HE, Gathright JB, McMullen KM, Hicks TC, Timmcke AE (1992) Rectal carcinoids: the most frequent carcinoid tumor. Dis Colon Rectum 35: 717–725
Koura AN, Giacco GG, Curley SA (1997). Carcinoid tumors of the rectum: effect of size, histopathology, and surgical treatment on metastasis-free survival. Cancer 79: 1294–1298
Martin S, Bruno N, Michael H, Bela T, Friedrich L, Klaus K, Rainer S (1988) Stage-dependent therapy of rectal carcinoid tumors. World J Surg 22: 628–634
Matsui K, Iwase T, Kitagawa M (1993) Small polypoid-appearing carcinoid tumors of the rectum: clinicopathologic study of 16 cases and effectiveness of endoscopic treatment. Am J Gastroenterol 88: 1949–1953
McDermott EWM, Guduric B, Brennan MF (1994) Prognostic variables in patients gastrointestinal carcinoid tumors. Br J Surg 81 1007–1009
Moesta KT, Schlag P (1990) Proposal for a new carcinoid tumor staging system based on tumor tissue infiltration and primary metastasis; a prospective multicenter carcinoid tumor evaluation study. Eur J Surg Oncol 16: 280–288
Parks AG (1968) A technique for exciting extensive villous papillomatous change in the lower rectum. Proc R Soc Med 61: 441–442
Sauven P, Ridge JA, Quan SH, Shgurdson ER (1990) Anorectal carcinoid tumors: is aggressive surgery warranted? Ann Surg 211: 67–71
Shirouzu K, Isomoto H, Kakegawa T, Morimatsu M (1990) Treatment of rectal carcinoid tumors. Am J Surg 160: 262–265
Soga J (1994) Carcinoid tumors: a statistical analysis of Japanese series of 3,126 reported and 1,180 autopsy cases. Acta Med Biol 42: 87–102
Tanaka J, Shindo Y, Kotanagi H (1996) Laparoscopically assisted resection of the lower rectum. Surg Endosc 10: 338–340 DOI: 10.1007/s004649910056
Thompson GB, Herden JA, Martin JK, Schutt AJ, Ilstrup DM, Carney JA (1985) Carcinoid tumors of gastrointestinal tract: presentation, management, and prognosis. Surgery 98: 1054–1063
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Online publication: 12 December 2000
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Araki, Y., Isomoto, H. & Shirouzu, K. Clinical efficacy of video-assisted gasless transanal endoscopic microsurgery (TEM) for rectal carcinoid tumor. Surg Endosc 15, 402–404 (2001). https://doi.org/10.1007/s004640000332
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DOI: https://doi.org/10.1007/s004640000332