“Transanal endoscopic microsurgery” with a flexible colonoscope (F-TEM): a new endoscopic treatment for suspicious deep submucosal invasion T1 rectal carcinoma
- 25.05.2023
- Dynamic Manuscript
Erschienen in:
- Verfasst von
- Flavius-Stefan Marin
- Einas Abou Ali
- Arthur Belle
- Frédéric Beuvon
- Romain Coriat
- Stanislas Chaussade
- Erschienen in
- Surgical Endoscopy | Ausgabe 7/2023
Abstract
Background
Endoscopic techniques allow resections of deep submucosal invasion rectal carcinoma, but mostly are facing issues such as costs, follow-up care or size limit. Our aim was to design a new endoscopic technique, which retains the advantages over surgical resections while eliminating the disadvantages mentioned above.
Patients and methods
We propose a technique for the resection of the superficial rectal tumours, with highly suspicious deep submucosal invasion. It combines steps of endoscopic submucosal dissection, muscular resection and edge-to-edge suture of the muscular layers, finally performing the equivalent of a “transanal endoscopic microsurgery” with a flexible colonoscope (F-TEM).
Results
A 60-year-old patient was referred to our unit, following the discovery of a 15 mm distal rectum adenocarcinoma. The computed tomography and the endoscopic ultrasound examination revealed a T1 tumour, without secondary lesions. Considering that the initial endoscopic evaluation highlighted a depressed central part of the lesion, with several avascular zones, an F-TEM was performed, without severe complication. The histopathological examination revealed negative resection margins, without risk factors for lymph node metastasis, no adjuvant therapy being proposed.
Conclusion
F-TEM allows endoscopic resection of highly suspicious deep submucosal invasion T1 rectal carcinoma and it proves to be a feasible alternative to surgical resection or other endoscopic treatments as endoscopic submucosal dissection or intermuscular dissection.
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- Titel
- “Transanal endoscopic microsurgery” with a flexible colonoscope (F-TEM): a new endoscopic treatment for suspicious deep submucosal invasion T1 rectal carcinoma
- Verfasst von
-
Flavius-Stefan Marin
Einas Abou Ali
Arthur Belle
Frédéric Beuvon
Romain Coriat
Stanislas Chaussade
- Publikationsdatum
- 25.05.2023
- Verlag
- Springer US
- Erschienen in
-
Surgical Endoscopy / Ausgabe 7/2023
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218 - DOI
- https://doi.org/10.1007/s00464-023-10141-7
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