Full-thickness intraperitoneal excision by transanal endoscopic microsurgery does not increase short-term complications.

Abstract:

PURPOSE:Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for full-thickness excision of benign and malignant rectal neoplasms located 4 to 24 cm above the anal verge. Entrance into the peritoneal cavity during TEM has been regarded as a complication that mandates conversion to open laparotomy for adequate repair of the defect. This study compares the rate of complications arising from TEM with and without intraperitoneal entry. METHODS:Patients undergoing peritoneal entry were compared to those who did not. RESULTS:No perioperative deaths occurred. There was no significant difference in the incidence of postoperative complications. No major complications occurred with peritoneal entry, and all peritoneal entries were closed transanally via endoscope. CONCLUSIONS:Entry into the peritoneum during TEM is not associated with an increased incidence of complication. Entry into the peritoneum during TEM excision does not mandate conversion to open laparotomy but may be safely repaired endoscopically. Lesions likely to be above the peritoneal reflection and within reach of the endoscope (4 to 24 cm) should be considered for TEM excision.

journal_name

Am J Surg

authors

Gavagan JA,Whiteford MH,Swanstrom LL

doi

10.1016/j.amjsurg.2004.01.004

subject

Has Abstract

pub_date

2004-05-01 00:00:00

pages

630-4

issue

5

eissn

0002-9610

issn

1879-1883

pii

S0002961004000212

journal_volume

187

pub_type

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