Тransanal endoscopic operations in rectal tumors
Objective. To improve diagnosis and results of treatment in patients, suffering rectal tumors, using transanal endoscopic microsurgery and studying of sentinel lymphatic nodes.
Маterials and methods. In 2009 – 2017 yrs in the Clinic transanal endoscopic operations were performed in 115 patients, ageing 29 – 82 yrs old. Tubulo–villous rectal adenoma was in 92 patients, of them in 26 histological investigation of the tumors excised have revealed malignization (TisN0M0). In 23 patients early cancer recti Т1–2N0M0 was revealed preoperatively.
Results. During follow–up 12 – 60 mo the recurrence was revealed in 2 (2.2%) patients, suffering adenoma, and in 3 (13%) – suffering cancer recti. Recurrence of cancer have occurred in patients, who rejected conduction of chemotherapy and radiation therapy.
Conclusion. Іdentification and precise investigation of sentinel lymphatic nodes in patients, suffering cancer recti makes possible a trustworthy (sensitivity=0.89, specificity=0.99) estimation of the disease and application of adequate scheme of combined and complex treatment of the patient.
2. Konishi T, Kuroyanagi H, Oya M, Ueno M, Fujimoto Y, Akiyoshi T, et al. Multimedia article. Lateral lymph nodedissection with preoperative chemoradiation for locally advanced lower rectal cancerthrough a laparoscopic approach. Surg Endosc. 2011 Jul;25(7):2358-9. https://doi.org/10.1007/s00464-010-1531-y.
3. Quadros CA, Falcao MF, Carvalho ME, Ladeia PA, Lopes A. Metastases to retroperitoneal or lateralpelvic lymph nodes indicated unfavorable survival and high pelvic recurrence rates in acohort of 102 patients with low rectal adenocarcinoma. J Surg Oncol. 2012 Nov;106(6):653-8. https://doi.org/10.1002/jso.23144.
4. Lezoche E, Baldarelli M, Lezoche G, Paganini AM, Gesuita R, Guerrieri M. Randomized clinical trial of endoluminal locoregional resection versus laparoscopic total mesorectal excision for T2 rectal cancer after neoadjuvant therapy. Br J Surg. 2012 Sep;99(9):1211-8. https://doi.org/10.1002/bjs.8821.
5. Morino M, Risio M, Bach S, Beets-Tan R, Bujko K, Panis Y, et al. Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference. Surg Endosc. 2015 Apr;29(4):755-73. https://doi.org/10.1007/s00464-015-4067-3.
6. Bilhim T, Pereira JA, Tinto HR, Fernandes L, Duarte M, O'Neill JE, et al. Middle rectal artery: myth or reality? Retrospective study with CT angiography and digital subtraction angiography. Surg Radiol Anat. 2013 Aug;35(6):517-22. https://doi.org/10.1007/s00276-012-1068-y.
7. Yermakov AV, Saribekyan EK, Ablitsova NV, Usov FN. Storozhevyye limfatichesike uzly pri zlokachestvennykh novoobrazovaniyakh. Zlokachestvennyye opukholi. 2017;1(22):70-7. https://doi.org/10.18027/2224-5057-2017-1-70-77 [In Russian].
8. Allaix ME, Arezzo A, Arolfo S, Caldart M, Rebecchi F, Morino M. Transanal endoscopic microsurgery for rectal neoplasms. How I do it. J Gastrointest Surg. 2013; Mar;17(3):586-92. https://doi.org/10.1007/s11605-012-2060-x.
9. Wu Y, Wu YY, Li S, Zhu BS, Zhao K, Yang XD, et al. TEM and conventional rectal surgery for T1 rectal cancer: a meta-analysis. Hepatogastroenterology. 2011 Mar-Apr;58(106):364-8. PMID: 21661397.
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