TY - JOUR
T1 - Minimally invasive transgery for early cancer in the upper rectum for cure and a better quality of life
AU - Maeda, Koutarou
AU - Maruta, Morito
AU - Utsumi, Toshiaki
AU - Tohyama, Kunihiro
AU - Sato, Harunobu
AU - Okumura, Yoshihiro
AU - Masumori, Kohji
AU - Koide, Yoshikaju
AU - Matsumoto, Masahisa
PY - 1998
Y1 - 1998
N2 - Minimally invasive transanal surgry (MITAS) was performed for early cancer without massive invasion into the submucosal layer in the upper rectum, which is not suitable for endoscopic or conventional transanal excision. Twenty-eight patients underwent MITAS for 29 rectal tumors (mucosal cancer 17, slight submucosal invasion 6, moderate submucosal invasion 5, massive submucosal invasion 1). The mean maximum diameter of the tumors was 26 mm, and the mean distance from the anal verge to the proximal margin of the tumor was 9.2 cm. Sixty-six percent of the tumors were located above the peritoneal reflection. Shortening and invagination of the rectum was initially performed using the E type anal retractor. The tumor was excised and simultanous anastomosis by a stapler following stiching under the tumor for pulling out the tumor. The mean operative time and blood loss were 23 minutes and 21 g respectively. There was no mortality or morbidity except one case of transient bleeding. Oral intake was started the day following the operation. The mean discharge day was about 5 days after the operation. The longest follow up was 3 years and 8 months. There was one recurrence, which was only surgical margin positive, and it was reexcised by MITAS. No further recurrent cases have been observed so far including the reexcised case. MITAS was considered to be a minimally invasive local excision procedure for cure and a better quality of life.
AB - Minimally invasive transanal surgry (MITAS) was performed for early cancer without massive invasion into the submucosal layer in the upper rectum, which is not suitable for endoscopic or conventional transanal excision. Twenty-eight patients underwent MITAS for 29 rectal tumors (mucosal cancer 17, slight submucosal invasion 6, moderate submucosal invasion 5, massive submucosal invasion 1). The mean maximum diameter of the tumors was 26 mm, and the mean distance from the anal verge to the proximal margin of the tumor was 9.2 cm. Sixty-six percent of the tumors were located above the peritoneal reflection. Shortening and invagination of the rectum was initially performed using the E type anal retractor. The tumor was excised and simultanous anastomosis by a stapler following stiching under the tumor for pulling out the tumor. The mean operative time and blood loss were 23 minutes and 21 g respectively. There was no mortality or morbidity except one case of transient bleeding. Oral intake was started the day following the operation. The mean discharge day was about 5 days after the operation. The longest follow up was 3 years and 8 months. There was one recurrence, which was only surgical margin positive, and it was reexcised by MITAS. No further recurrent cases have been observed so far including the reexcised case. MITAS was considered to be a minimally invasive local excision procedure for cure and a better quality of life.
UR - http://www.scopus.com/inward/record.url?scp=54749134661&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=54749134661&partnerID=8YFLogxK
U2 - 10.5833/jjgs.31.1028
DO - 10.5833/jjgs.31.1028
M3 - Article
AN - SCOPUS:54749134661
SN - 0386-9768
VL - 31
SP - 1028
EP - 1032
JO - Japanese Journal of Gastroenterological Surgery
JF - Japanese Journal of Gastroenterological Surgery
IS - 4
ER -