Clinical results of transanal endoscopic microsurgery

G. Bueß1, K. Kipfmüller1, R. Ibald1, A. Heintz1, D. Hack1, S. Braunstein2, H. Gabbert2, T. Junginger1
1Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes Gutenberg-Universität, Mainz 1, Germany
2Institut für Pathologie, Johannes Gutenberg-Universität, Mainz 1, Germany

Tóm tắt

Using the “transanal endoscopic microsurgery” technique, 140 patients were treated at the Department of Surgery in Cologne and Mainz. Of the patients with adenomas, 68.2% had typical symptoms preoperatively. The postoperative hospital attendance was 8.7 days, with an average resection size of 14.4 cm2. The postoperative complication rate was 5%, and there were no deaths related to the technique. In a prospective controlled trial, 2.2% of the patients with adenomas treated endoscopically in Mainz showed recidivation, requiring reoperation. The follow-up rate was 100%. In 30 cases, microscopic examination revealed carcinoma. Radical reoperation in 8 pT1 tumours showed neither remaining tumour nor lymph node metastases. Twelve patients with pT1 carcinoma treated by local surgery alone were recurrence-free with an average follow-up period of 12.3 months. So far, there have been no late results.

Tài liệu tham khảo

Bueß G, Hutterer F, Theiß J, Böbel M, Isselhard W, Pichlmaier H (1984) Das System für die transanale endoskopische Rectumoperation. Chirurg 55: 677–680 Bueß G, Kipfmüller K, Hack D, Grüßner R, Heintz A, Junginger T (1988) Technique of transanal endoscopic microsurgery. Surg Endosc 2: 71–75 Frimberger E, Kühner W, Seib HJ, Ottenjann R (1978) Kolorektale Adenome. Dtsch Med Wochenschr 103: 649–652 Grigg M, McDermott FT, Phil EA, Hughes ES (1984) Curative local excision in the treatment of carcinoma of the rectum. Dis Colon Rectum 27: 81 Häring R, Karavias T, Konradt J (1978) Die posteriore Proctorectotomie. Chirurg 49: 265–271 Hermanek P, Gall FP (1986) Early (microinvasive) colorectal carcinoma. Pathology, diagnosis, surgical treatment. Int J Colorect Dis 1: 79–84 Kronborg O (1980) Review. Polyps of the colon and rectum: approach to prophylaxis in colorectal cancer. Scand J Gastroenterol 15: 1–5 Morson BC, Sobin LH (1976) Histological typing of intestinal tumors. (International histological classification of tumors, vol 15) WHO, Geneva, p 56 Nöthiger F (1985) Technique and results of peranal excision of rectal malignoma. Helv Chir Acta 52: 325 Schiessel R, Wunderlich M, Karner-Hanusch J (1986) Transanale Excision und Anastomosentechnik. Chirurg 57: 773–778 Schildberg FW, Wenk H (1986) Der posteriore Zugang zum Rectum. Chirurg 57: 779–791