- MeSH
- Surgical Staplers statistics & numerical data MeSH
- Laparoscopy methods statistics & numerical data MeSH
- Humans MeSH
- Proctoscopy methods statistics & numerical data MeSH
- Rectal Prolapse * surgery etiology classification physiopathology MeSH
- Transanal Endoscopic Surgery methods statistics & numerical data MeSH
- Check Tag
- Humans MeSH
Transanální endoskopická mikrochirurgie (TEM) zajišťuje exaktní excizi lokálních, tumorózních lezí rekta. Tato technika vyžadující specializovaného operatéra a dlouhodobé zkušenosti doznala po zavedení harmonického skalpelu značného zjednodušení. V souboru 54 operovaných pacientů v letech 2008–2013 technikou TEM bylo 25 s karcinomem rekta. Z tohoto počtu byl u 40 % pacientů karcinom diagnostikován až z definitivního histologického vyšetření. Recidiva karcinomu do jednoho roku byla zjištěna ve třech případech. TEM je konsenzuálně přijímaným způsobem léčby karcinomu rekta u polymorbidních rizikových pacientů. Lokální léčba biopticky a endorektální sonografií ověřených T1N0 karcinomů u pacientů schopných resekčního výkonu je nadále kontroverzní. Klíčová slova: transanální endoskopická mikrochirurgie – rektální adenom – časný rektální karcinom
Transanal endoscopic microsurgery (TEM) enables the surgeon to perform precise local excision of local rectal tumorous lesions. This technique requiring a specialized surgeon with extensive experience, was significantly simplified after the introduction of the harmonic scalpel. In a group of 54 patients treated with this TEM technique between 2008 and 2013, 25 had rectal carcinoma. In 40% of these 25 patients, the final diagnosis was based on a histological examination of a resected specimen postsurgically. Recurrent carcinomas were identified in three cases within one year. TEM is an accepted treatment modality of rectal carcinomas in elderly polymorbid high risk patients. Local treatment of endosonographically and bioptically verified T1N0 carcinomas in patients who are able to undergo surgical resection treatment is still controversial. Key words: transanal endoscopic microsurgery – rectal adenoma – early rectal carcinoma The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers. Submitted: 19. 1. 2014 Accepted: 8. 9. 2014
- MeSH
- Adenocarcinoma surgery pathology MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Recurrence, Local MeSH
- Microsurgery * methods statistics & numerical data MeSH
- Rectal Neoplasms * surgery pathology MeSH
- Intraoperative Complications MeSH
- Postoperative Complications MeSH
- Proctoscopy * methods statistics & numerical data MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Carcinoma, Squamous Cell surgery pathology MeSH
- Neoplasm Staging MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
