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Transanal Endoscopic Operation for Rectal Tumor: Short-term Outcomes and Learning Curve Analysis

Authors
 Hur, Hyuk  ;  Bae, Sung Uk  ;  Han, Yoon Dae  ;  Kang, Jeonghyun  ;  Min, Byung Soh  ;  Baik, Seung Hyuk  ;  Lee, Kang Young  ;  Kim, Nam Kyu 
Citation
 SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, Vol.26(3) : 236-243, 2016 
Journal Title
 SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES 
ISSN
 1530-4515 
Issue Date
2016
MeSH
Adult ; Aged ; Aged, 80 and over ; Feasibility Studies ; Female ; Humans ; Learning Curve ; Male ; Microsurgery/methods ; Middle Aged ; Operative Time ; Postoperative Care/methods ; Postoperative Complications/etiology ; Proctoscopy/methods* ; Rectal Neoplasms/surgery* ; Salvage Therapy/methods ; Treatment Outcome
Abstract
PURPOSE: We aim to report outcomes and learning curve of transanal endoscopic operation (TEO) for rectal tumors, using standard laparoscopic instruments under a magnifying laparoscopic monitor view. MATERIALS AND METHODS: From January 2012 to July 2014, local excision was performed using a TEO system in 46 consecutive patients with rectal tumors. Patient and tumor characteristics and perioperative outcomes were prospectively assessed. RESULTS: The median patient age was 56 years for 15 women and 31 men. The mean tumor size was 1.8 cm, and the mean distance from the anal verge was 7.8 cm. The mean operative time was 85 minutes, and the mean postoperative hospital stay was 4.5 days. The postoperative pathologic diagnosis was adenocarcinoma for 17 patients (37%), adenoma for 4 patients (9%), carcinoid tumor for 23 patients (50%), and leiomyoma and lipoma for the 2 remaining patients (2%). A positive resection margin was documented for 4 patients (9%). No mortality was associated with the procedure although postoperative bleeding, leakage, perianal fistula, fecal incontinence, and voiding difficulty developed in 8 patients. According to the cumulative sum (CUSUM) analysis, the operation time and hospital stay significantly decreased after 17 case experiences. CONCLUSIONS: TEO is a feasible and safe treatment option for local excision of rectal tumors. TEO has the advantage of being a precise surgical procedure with a stable and magnifying endoscopic view. However, TEO requires a learning period and a careful selection of patients through proper indications and preoperative diagnostics.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00129689-201606000-00011&LSLINK=80&D=ovft
DOI
10.1097/SLE.0000000000000258
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Jeonghyun(강정현) ORCID logo https://orcid.org/0000-0001-7311-6053
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Lee, Kang Young(이강영)
Han, Yoon Dae(한윤대) ORCID logo https://orcid.org/0000-0002-2136-3578
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152407
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