Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity...Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity and to improve both the oncological as well as the functional outcomes, have been emerged. Literature suggest that when the intersphincteric resection is applied in T1-3 tumors located within 30-35 mm from the anal verge, is technically feasible, safe, with equal oncological outcomes compared to conventional surgery and acceptable quality of life. The Anterior Perineal Plan E for Ultra-low Anterior Resection technique, is not disrupting the sphincters, but carries a high complication rate, while the reports on the oncological and functional outcomes are limited. Transanal Endoscopic Micro Surgery(TEM) and Trans Anal Minimally Invasive Surgery(TAMIS) should represent the treatment of choice for T1 rectal tumors, with specific criteria according to the NCCN guidelines and favorable pathologic features. Alternatively to the standard conventional surgery, neoadjuvant chemo-radiotherapy followed by TEM or TAMIS seems promising for tumors of a local stage T1sm2-3 or T2. Transanal Total Mesorectal Excision should be performed only when a board approved protocol is available by colorectal surgeons with extensive experience in minimally invasive and transanal endoscopic surgery.展开更多
Objective: To report the development of atechnique for minimally invasive thyroid lobectomy.Method: The procedure was accepted by 200 patientswith a nodule of the lobe of the thyroid. We performed hemithyroidectomys...Objective: To report the development of atechnique for minimally invasive thyroid lobectomy.Method: The procedure was accepted by 200 patientswith a nodule of the lobe of the thyroid. We performed hemithyroidectomys thyroidectomys through a 2-3 cm low-collar horizontal skin incision by conventionalinstrumentation. Results: The recurrent laryngealnerve and the parathyroid glands were easily identifiedand preserved. The amount of bleeding ranged from 5 to50 ml (mean 15 ml). Mean Operation time was 52.2minutes (ranged 32 to 80 minutes). No complicationoccurred. Mean postoperative stay was 5.5 days(ranged 4 to 7 days). The incision provided excellentcometic results because the small and lower incisionswere completely hidden by clothing collar. Conclusion: The above technique is feasible, safe, minimallyinvasive, less time and cost consuming and cosmetical.展开更多
文摘Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity and to improve both the oncological as well as the functional outcomes, have been emerged. Literature suggest that when the intersphincteric resection is applied in T1-3 tumors located within 30-35 mm from the anal verge, is technically feasible, safe, with equal oncological outcomes compared to conventional surgery and acceptable quality of life. The Anterior Perineal Plan E for Ultra-low Anterior Resection technique, is not disrupting the sphincters, but carries a high complication rate, while the reports on the oncological and functional outcomes are limited. Transanal Endoscopic Micro Surgery(TEM) and Trans Anal Minimally Invasive Surgery(TAMIS) should represent the treatment of choice for T1 rectal tumors, with specific criteria according to the NCCN guidelines and favorable pathologic features. Alternatively to the standard conventional surgery, neoadjuvant chemo-radiotherapy followed by TEM or TAMIS seems promising for tumors of a local stage T1sm2-3 or T2. Transanal Total Mesorectal Excision should be performed only when a board approved protocol is available by colorectal surgeons with extensive experience in minimally invasive and transanal endoscopic surgery.
文摘Objective: To report the development of atechnique for minimally invasive thyroid lobectomy.Method: The procedure was accepted by 200 patientswith a nodule of the lobe of the thyroid. We performed hemithyroidectomys thyroidectomys through a 2-3 cm low-collar horizontal skin incision by conventionalinstrumentation. Results: The recurrent laryngealnerve and the parathyroid glands were easily identifiedand preserved. The amount of bleeding ranged from 5 to50 ml (mean 15 ml). Mean Operation time was 52.2minutes (ranged 32 to 80 minutes). No complicationoccurred. Mean postoperative stay was 5.5 days(ranged 4 to 7 days). The incision provided excellentcometic results because the small and lower incisionswere completely hidden by clothing collar. Conclusion: The above technique is feasible, safe, minimallyinvasive, less time and cost consuming and cosmetical.
