Annals of Coloproctology

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Transanal Endoscopic Microsurgery for Patients With Rectal Tumors: A Single Institution's Experience: Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius; Ann Coloproctol. 2017;33(1):23-27. Published online February 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.1.23

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15 Citations

Purpose

The purpose of this study was to look at our complication rates and recurrence rates, as well as the need for further radical surgery, in treating patients with benign and early malignant rectal tumors by using transanal endoscopic microsurgery (TEM).

Methods

Our study included 130 patients who had undergone TEM for rectal adenomas and early rectal cancer from December 2009 to December 2015 at the Department of Surgical Oncology, National Cancer Institute, Lithuania. Patients underwent digital and endoscopic evaluation with multiple biopsies. For preoperative staging, pelvic magnetic resonance imaging or endorectal ultrasound was performed. We recorded the demographics, operative details, final pathologies, postoperative lengths of hospital stay, postoperative complications, and recurrences.

Results

The average tumor size was 2.8 ± 1.5 cm (range, 0.5–8.3 cm). 102 benign (78.5%) and 28 malignant tumors (21.5%) were removed. Of the latter, 23 (82.1%) were pT1 cancers and 5 (17.9%) pT2 cancers. Of the 5 patients with pT2 cancer, 2 underwent adjuvant chemoradiotherapy, 1 underwent an abdominoperineal resection, 1 refused further treatment and 1 was lost to follow up. No intraoperative complications occurred. In 7 patients (5.4%), postoperative complications were observed: urinary retention (4 patients, 3.1%), postoperative hemorrhage (2 patients, 1.5%), and wound dehiscence (1 patient, 0.8%). All complications were treated conservatively. The mean postoperative hospital stay was 2.3 days.

Conclusion

TEM in our experience demonstrated low complication and recurrence rates. This technique is recommended for treating patients with a rectal adenoma and early rectal cancer and has good prognosis.

Citations

Citations to this article as recorded by

TEMPOUR: A Randomized Controlled Trial Assessing Perioperative Use of an Alpha-1 Blocker to Reduce Postoperative Urinary Retention After Transanal Endoscopic Microsurgery Procedures
Thomas Couture, Claudya Morin, Janyssa Charbonneau, Émilie Papillon-Dion, Alexandre Bouchard, François Rouleau-Fournier, Philippe Bouchard, François Letarte, Alexis F. Turgeon, Sebastien Drolet
Diseases of the Colon & Rectum.2025; 68(4): 475. CrossRef
The Outcome of Local Excision of Rectal Adenomas with High-Grade Dysplasia by Transanal Endoscopic Microsurgery: A Single-Center Experience
Muhammad Khalifa, Rachel Gingold-Belfer, Nidal Issa
Journal of Clinical Medicine.2024; 13(5): 1419. CrossRef
Transanal endoscopic rectal resection: immediate and long-term results
A.A. Maslov, Yu.A. Gevorkyan, N.V. Soldatkina, A.V. Dashkov, S.I. Poluektov, V.E. Kolesnikov, D.O. Kaymakchi, A.V. Snezhko
Khirurgiya. Zhurnal im. N.I. Pirogova.2022; (1): 30. CrossRef
Complex Procedures in Transanal Endoscopic Microsurgery: Intraperitoneal Entry, Ultra Large Rectal Tumors, High Lesions, and Resection in the Anal Canal
Xavier Serra-Aracil, Victoria Lucas-Guerrero, Laura Mora-López
Clinics in Colon and Rectal Surgery.2022; 35(02): 129. CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
Is Local Resection of Anal Canal Tumors Feasible with Transanal Endoscopic Surgery?
Xavier Serra‐Aracil, Andrea Campos‐Serra, Laura Mora‐López, Sheila Serra‐Pla, Anna Pallisera‐Lloveras, Roser Flores‐Clotet, Alba Zárate‐Pinedo, Salvador Navarro‐Soto
World Journal of Surgery.2020; 44(3): 939. CrossRef
Transanal endoscopic microsurgery for a rectal polyp – a video vignette
N. E. Samalavicius, P. Kavaliauskas, A. Dulskas
Colorectal Disease.2020; 22(9): 1203. CrossRef
Endoscopic diagnosis of gastrointestinal melanoma
Sheng Wang, Siyu Sun, Xiang Liu, Nan Ge, Guoxin Wang, Jintao Guo, Wen Liu, Jinlong Hu
Scandinavian Journal of Gastroenterology.2020; 55(3): 330. CrossRef
Is Previous Transanal Endoscopic Microsurgery for Early Rectal Cancer a Risk Factor of Worse Outcome following Salvage Surgery A Case-Matched Analysis
Audrius Dulskas, Aivaras Atkociunas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius
Visceral Medicine.2019; 35(3): 151. CrossRef
Transanal endoscopic microsurgery for rectal lesions in a specialist regional early rectal cancer centre: the Mersey experience
M. Ondhia, P. Tamvakeras, P. O'Toole, A. Montazerri, T. Andrews, C. Farrell, S. Ahmed, S. Slawik, S. Ahmed
Colorectal Disease.2019; 21(10): 1164. CrossRef
Transanal Endoscopic Microsurgery for Patients with Rare Rectal Tumors
Xin Wu, Guole Lin, Huizhong Qiu, Jiaolin Zhou
Journal of Laparoendoscopic & Advanced Surgical Techniques.2018; 28(5): 546. CrossRef
Modern management of T1 rectal cancer by transanal endoscopic microsurgery: a 10‐year single‐centre experience
H. J. S. Jones, R. Hompes, N. Mortensen, C. Cunningham
Colorectal Disease.2018; 20(7): 586. CrossRef
Transanal endoscopic microsurgery as day surgery – a single‐centre experience with 500 patients
C. J. Brown, J. Q. Gentles, T. P. Phang, A. A. Karimuddin, M. J. Raval
Colorectal Disease.2018;[Epub] CrossRef
Transanal Endoscopic Microsurgery
Byung Chun Kim
Annals of Coloproctology.2017; 33(1): 5. CrossRef
Transanal endoscopic microsurgery for giant benign rectal tumours: is large size a contraindication?
Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius
International Journal of Colorectal Disease.2017; 32(12): 1759. CrossRef

Association Between Exposure to Environmental Tobacco Smoke at the Workplace and Risk for Developing a Colorectal Adenoma: A Cross-Sectional Study: Seung-Hwa Lee, Ji-Yeon Hong, Jung-Un Lee, Dong Ryul Lee; Ann Coloproctol. 2016;32(2):51-57. Published online April 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.2.51

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40 Download
4 Web of Science
5 Citations

Abstract PDF

Purpose

A colorectal adenoma (CRA) is a well-defined precursor to colorectal cancer (CRC). Additionally, smoking is a potent risk factor for developing a CRA, as well as CRC. However, the association between exposure to environmental tobacco smoke (ETS) and the risk for developing a CRA has not yet been fully evaluated in epidemiologic studies. We performed a cross-sectional analysis on the association between exposure to ETS at the workplace and the risk for developing a CRA.

Methods

The study was conducted on subjects who had undergone a colonoscopy at a health promotion center from January 2012 to December 2012. After descriptive analyses, overall and subgroup analyses by smoking status were performed by using a multivariate logistic regression.

Results

Among the 1,129 participants, 300 (26.6%) were diagnosed as having CRAs. Exposure to ETS was found to be associated with CRAs in all subjects (fully adjusted odds ratio [OR], 1.95; 95% confidence interval [CI], 1.08–2.44; P = 0.001). In the subgroup analysis, exposure to ETS in former smokers increased the risk for developing a CRA (fully adjusted OR, 4.44; 95% CI, 2.07–9.51; P < 0.001).

Conclusion

Exposure to occupational ETS at the workplace, independent of the other factors, was associated with increased risk for developing a CRA in all subjects and in former smokers. Further retrospective studies with large sample sizes may be necessary to clarify the causal effect of this relationship.

Citations

Citations to this article as recorded by

Epidemiological and clinicopathological characteristics of colorectal cancer patients in tertiary hospital in West Java
Kiki Lukman, Arrayyan Muhammad, Mohammad Ghozali, Prapanca Nugraha, Yunia Sribudiani, Bistamy Muhammad Nursabur
Clinical Epidemiology and Global Health.2024; 28: 101688. CrossRef
RISK FACTORS OF COLORECTAL CANCER IN SULAIMANI CITY
Mohammed Hassan, Kameran Ismail, Zhian Ramzi, Tariq Al-Hadithi
JOURNAL OF SULAIMANI MEDICAL COLLEGE.2018; 8(1): 47. CrossRef
Plausible Roles for RAGE in Conditions Exacerbated by Direct and Indirect (Secondhand) Smoke Exposure
Joshua Lewis, Kelsey Hirschi, Juan Arroyo, Benjamin Bikman, David Kooyman, Paul Reynolds
International Journal of Molecular Sciences.2017; 18(3): 652. CrossRef
Metformin therapy and the risk of colorectal adenoma in patients with type 2 diabetes: A meta-analysis
Yi-Chao Hou, Qiang Hu, Jiao Huang, Jing-Yuan Fang, Hua Xiong
Oncotarget.2017; 8(5): 8843. CrossRef
Exposure to Cigarette Smoke Contributes to the Risk of Developing a Colorectal Adenoma, Doesn't It? Are Repeated Exposures to Such Smoke Dangerous?
Bong Hwa Lee, Min Jung Kim, Hyoung Chul Park
Annals of Coloproctology.2016; 32(2): 43. CrossRef

Expression of a Novel 90 kDa Heat Shock Protein in Colorectal Tumor.: Choi, Dae Hwa , Cho, Hong Rae , Ko, Byung Kyun , Nah, Yang Won , Nam, Chang Woo , Kim, Gyu Yeol , Im, Young Cheol , Park, Kun Choon , Kim, Do Ha , Park, Jae Hoo , Min, Young Joo , Suh, Fae Hee , Park, Jeong Woo; J Korean Soc Coloproctol. 2002;18(1):1-6.

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27 Download

Abstract PDF: PURPOSE
When cells are subjected to a wide variety of stressful stimuli, they respond by increasing the synthesis of specific stress proteins. Stresses include heat shock, nutrient deprivation, oxygen radicals, toxic metal and viral infection. Major stress proteins are Hsp 27, Hsp 60, Hsp 70 (9), Hsp 90 (3) and Hsp 100 (1). Previously a novel 90 kDa stress protein has been reported to be induced in fish cells by virus infection. The novel 90 kDa stress protein is different from well-known major stress protein in size, antigenicity, cellular localization. The novel 90 kDa stress protein was found to be present in various kinds of cells including human cells and its expression was increased in human carcinomas. The purpose of this study is to evaluate the expression of the novel 90 kDa stress protein in human colonic mucosa of normal tissue, adenoma and adenocarcinoma using immunohistochemical method.
METHODS
85 colon tissues were screened for the expression of the novel 90 kDa stress protein; 85 normal colonic mucosa, 20 colonic adenoma and 65 colonic adenocarcinoma. The tissues were stained with monoclonal antibody against the novel 90 kDa stress protein. In scoring system, tissue sections with immunostained area above 10 % were decided to be positive and, among the positive, the tissue sections were divided into three score, 1, 2, and 3, based on the staining intensity and positive area proportion. The tissue sections with immunostained area below 10% were decided to be negative and grouped into 0 score. Correlation of immunohistochemical expression was analysed by using SPSS version 10.0 statistically.
RESULTS
The expression of the 90 kDa stress protein was significantly different among normal colonic mucosa, colonic adenoma, and colonic adenocarcinoma and the percentage of positive samples were 14.1%, 80.5%, and 95.4% respectively. This result suggests that the expression level of the novel 90 kDa stress protein was extremely low in normal tissue but increased significantly in adenocarcinomatous tissues.
CONCLUSIONS
The expression of the novel 90 kDa stress protein was increased significantly with transformation of the normal colon tissue to malignancy. This suggests the possibility that this novel 90 kDa stress protein play some role in cancerous transformation of colon tissue.

Expression of p27 Protein in Adenoma and Adenocarcinoma of the Colorectum.: Son, Hyun Jin , Kang, Myoung Jae; J Korean Soc Coloproctol. 2001;17(5):251-258.

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13 Download

Abstract PDF: PURPOSE
The cyclin-dependent kinase inhibitor p27kip1 protein is a negative regulator of the cell division cycle, and its degradation is required for entry into the S phase. Loss of p27(kip1) protein expression has been reported to be associated with aggressive behavior in a variety of tumors of epithelial and lymphoid origin. The purpose of this study was to determine the expression of p27 protein in adenoma and adenocarcinoma of the colorectum and to assess the prognostic significance.
METHODS
We performed immunohistochemical staining for expression of p27 protein in adenomas (20 cases) and adenocarcinomas (30 cases) of the colorectum. The data (p27 protein labeling index (LI, mean+/-standard deviation)) were analyzed in association with clinicopathologic parameters.
RESULTS
p27 protein LI of normal mucosa (10 cases), adenoma, and adenocarcinoma were 93.3+/-4.5, 65.4+/-17.5, and 28.2+/- 14.5, respectively (p<0.0001). p27 protein LI of well differentiated adenocarcinoma was slightly higher than those of moderately and/or poorly differentiated adenocarcinoma, but did not show any significant difference among these groups (p=0.19). Also p27 protein expression did not show any significant relationship to other prognostic facters such as age, invasion depth, and operative staging.
CONCLUSIONS
The results suggested that reduced expression of p27 protein may play an important role in the malignant transformation process of colorectal cancer.

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