Surgical endoscopy · 2016
Feasibility of the TAMIS technique for redo pelvic surgery.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Borstlap W A A, Harran N, Tanis P J, Bemelman W A
Аннотация
AIM: The aim of this study was to report on the feasibility of transanal minimally invasive surgery (TAMIS) as a novel approach to redo colorectal or ileoanal anastomoses.
METHODS: From October 2014, a prospective institutional database was created for all consecutive patients who underwent redo surgery by TAMIS for presacral sinus or anastomotic stenosis after low anterior resection or pouch-related problems following restorative proctocolectomy. Intra-operative feasibility, 30-day postoperative outcomes, intestinal continuity and complications after 6-month follow-up were evaluated.
RESULTS: Of 17 included patients, 14 underwent anastomotic reconstruction and three completion proctectomy. The median operation time was 265 min (range 201-413). A successful rendezvous with simultaneous transabdominal access was achieved in 15 patients, and the procedure was completed by TAMIS alone in two. Five patients were readmitted within 30 days (29 %). Two (14 %) patients developed an anastomotic leakage within 30 days and 4 (24 %) developed a pelvic abscess requiring reintervention. One patient developed an urethra stenosis and was managed with a suprapubic catheter. Median follow-up was 9 (6-15) months. Within 6-month follow-up, the redo-TAMIS 1 patient developed a delayed anastomotic leak and 1 patient had a recurrent presacral abscess after stoma closure. Intestinal continuity was reached in 71 % of the patients at 6-month follow-up.
CONCLUSION: TAMIS is a valuable approach in redo pelvic surgery, but is still associated with high complication rates related to the complexity of the underlying problem.
METHODS: From October 2014, a prospective institutional database was created for all consecutive patients who underwent redo surgery by TAMIS for presacral sinus or anastomotic stenosis after low anterior resection or pouch-related problems following restorative proctocolectomy. Intra-operative feasibility, 30-day postoperative outcomes, intestinal continuity and complications after 6-month follow-up were evaluated.
RESULTS: Of 17 included patients, 14 underwent anastomotic reconstruction and three completion proctectomy. The median operation time was 265 min (range 201-413). A successful rendezvous with simultaneous transabdominal access was achieved in 15 patients, and the procedure was completed by TAMIS alone in two. Five patients were readmitted within 30 days (29 %). Two (14 %) patients developed an anastomotic leakage within 30 days and 4 (24 %) developed a pelvic abscess requiring reintervention. One patient developed an urethra stenosis and was managed with a suprapubic catheter. Median follow-up was 9 (6-15) months. Within 6-month follow-up, the redo-TAMIS 1 patient developed a delayed anastomotic leak and 1 patient had a recurrent presacral abscess after stoma closure. Intestinal continuity was reached in 71 % of the patients at 6-month follow-up.
CONCLUSION: TAMIS is a valuable approach in redo pelvic surgery, but is still associated with high complication rates related to the complexity of the underlying problem.