Written by the specialists who innovated these techniques in the lab and performed the first procedures on humans for early clinical trials
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.|
Transanal endoscopic microsurgery is a less invasive way to remove benign or malignant tumors from the rectum. Patients with small, early malignant tumors are candidates for TEM as are patients with benign tumors of any kind. As with all minimally invasive procedures, the advantage to the patient is the avoidance of a major wound and thus a quicker return to normal activities following surgery. Another benefit is that the need for a colostomy following TEM is rare whereas it is indicated more frequently after traditional procedures. TEM techniques have been around for a while (Buess published the first report of over 500 cases in 1999), but colorectal surgeons wanted proof that this approach would have favorable long-term outcomes for removal of malignant tumors. Data presented at the Society for Surgical Oncology meeting in March 2005 confirmed that TEM is a safe choice even with cancerous lesions, and now surgeons around the world want to learn these less invasive techniques. Transanal Endoscopic Microsurgery is the first book on the topic and covers everything: patient selection, operative approaches, oncologic results, and evidence-based comparisons to traditional approaches.
Indications.- Preoperative Preparation.- Equipment and Operative Set-up.- Pelvic Anatomic Considerations for Transanal Endoscopic Microsurgery.- Getting Started.- Partial-Thickness Excision.- Full-Thickness Excision.- Advanced Surgical Techniques.- Complications.- Comparison with Traditional Techniques.- Full-Thickness Local Excision.- Oncologic Outcomes.- Clinical Trials.- Future Directions.
Transanal Endoscopic Microsurgery: Principles and Techniques is the first book to present a complete review of an exciting developing technology. Cancer of the rectum remains a significant health problem, despite the increasing improvement of survival rates. The improvement in patient care comes from many sources: more accurate preoperative staging, aggressive neoadjuvant therapy and improved surgical techniques. Surgical extirpation continues to be the cornerstone of curative treatment of this potentially lethal disease. Transanal endoscopic microsurgery (TEM) is a technique for the performance of local excision by way of a binocular magnified operating system. Comparative trials demonstrate significantly better oncologic results for rectal cancer treated by TEM compared to conventional local excision. TEM provides a technically superior method for excision of rectal polyps and select early rectal cancers, with lower costs and fewer complications when compared to conventional approaches.
The editors and chapter authors of Transanal Endoscopic Microsurgery: Principles and Techniques are the world´s leading experts on TEM and their collective clinical experience is reflected in the practically oriented approach in every chapter. The text will prove to be an asset to any colorectal or general surgeon´s library.
Written by the innovators of these techniques, this book Covers every aspect of its subject, from indications and contraindications to operative techniques. Along with its accompanying DVD, it is an essential reference for surgeons who want to practice TEM.
Inhaltsverzeichnis
Indications.- Preoperative Preparation.- Equipment and Operative Set-up.- Pelvic Anatomic Considerations for Transanal Endoscopic Microsurgery.- Getting Started.- Partial-Thickness Excision.- Full-Thickness Excision.- Advanced Surgical Techniques.- Complications.- Comparison with Traditional Techniques.- Full-Thickness Local Excision.- Oncologic Outcomes.- Clinical Trials.- Future Directions.
Klappentext
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.
Transanal endoscopic microsurgery is a less invasive way to remove benign or malignant tumors from the rectum. Patients with small, early malignant tumors are candidates for TEM as are patients with benign tumors of any kind. As with all minimally invasive procedures, the advantage to the patient is the avoidance of a major wound and thus a quicker return to normal activities following surgery. Another benefit is that the need for a colostomy following TEM is rare whereas it is indicated more frequently after traditional procedures. TEM techniques have been around for a while (Buess published the first report of over 500 cases in 1999), but colorectal surgeons wanted proof that this approach would have favorable long-term outcomes for removal of malignant tumors. Data presented at the Society for Surgical Oncology meeting in March 2005 confirmed that TEM is a safe choice even with cancerous lesions, and now surgeons around the world want to learn these less invasive techniques. Transanal Endoscopic Microsurgery is the first book on the topic and covers everything: patient selection, operative approaches, oncologic results, and evidence-based comparisons to traditional approaches.
