Transanal Endoscopic Microsurgery

1. Front Matter

   Pages i-xiv

   PDF

2. Indications

   • Mark H. Whiteford

   Pages 1-5

3. Preoperative Preparation

   • Garnet J. Blatchford, N. Anh Tran

   Pages 7-11

4. Equipment and Operative Set-up

   • Lee E. Smith

   Pages 13-25

5. Pelvic Anatomic Considerations for Transanal Endoscopic Microsurgery

   • Peter A. Cataldo

   Pages 27-33

6. Getting Started

   • Patricia L. Roberts

   Pages 35-40

7. Partial-Thickness Excision

   • Peter A. Cataldo, Neil J. Mortensen

   Pages 41-45

8. Full-Thickness Excision

   • Emanuele Lezoche, Mario Guerrieri, Maddalena Baldarelli, Giovanni Lezoche

   Pages 47-58

9. Advanced Surgical Techniques

   • Prakash Gatta, Lee L. Swanstrom

   Pages 59-74

10. Complications

    • K. S. Khanduja

    Pages 75-84

11. Comparison with Traditional Techniques

    • Matthew R. Dixon, Charles O. Finne

    Pages 85-108

12. Full-Thickness Local Excision

    • Lauren A. Kosinski, John H. Marks, Gerald J. Marks

    Pages 109-115

13. Oncologic Outcomes

    • Joel E. Goldberg, Ronald Bleday

    Pages 117-124

14. Clinical Trials

    • Kim F. Rhoads, Julio E. Garcia-Aguilar

    Pages 125-133

15. Future Directions

    • Mark Choh, Theodore J. Saclarides

    Pages 135-139

16. Back Matter

    Pages 141-147

    PDF

Cancer of the rectum continues to be a significant health problem in industrialized co- tries around the world. Relative 5-year survival rates in the USA for cancer of the rectum from 1995 to 2001 improved to 65%, a 15% improvement over 20 years (American Cancer Society, 2007). The reasons for this dramatic improvement include more accurate pr- perative staging, aggressive neoadjuvant therapy and improved surgical technique as well as specialty-trained surgeons. Despite advances in nonoperative techniques of radiation therapy, chemotherapy and immunotherapy, surgical extirpation continues to be the cornerstone of curative treatment of this potentially lethal disease. Radical cancer excision with total mesorectal excision has become the preferred surgical procedure for even early-stage cancers of the rectum. Over the past decade the enthusiasm for local excision (and other local treatments) has given way to persuasive (predominantly retrospective) evidence that the incidence of locoregional recurrence due to unsuspected lymphatic metastases and positive lateral margins is un- ceptably high even for stage T tumors. Vigorous attempts to find characteristics of the 1 tumor that would allow successful local treatments are ongoing.

• Staging
• Surgery
• biopsy
• clinical trial
• endoscopy

Policies and ethics