Laparoscopic sigmoid resection with transrectal specimen extraction has a good short-term outcome.
Wolthuis AM, Penninckx F, D'Hoore A.
Surg Endosc. 2010 Dec 7. [Epub ahead of print]
PMID: 21136110 [PubMed - as supplied by publisher]

RESULTS: The described technique was used to treat 21 patients… There was one anastomotic leak (5%), treated by emergency laparotomy and creation of a new colorectal anastomosis. None of the patients required a temporary diverting stoma, and no postoperative mortality occurred.

CONCLUSIONS: Laparoscopic sigmoid resection with transrectal specimen extraction is feasible and has a good short-term outcome.

A novel single-port technique for transanal rectosigmoid resection and colorectal anastomosis on an ex vivo experimental model.
Bhattacharjee HK, Buess GF, Becerra Garcia FC, Storz P, Sharma M, Susanu S, Kirschniak A, Misra MC.
Surg Endosc. 2010 Dec 7. [Epub ahead of print]
PMID: 21136108 [PubMed - as supplied by publisher]

BACKGROUND: In the context of natural orifice translumenal endoscopic surgery (NOTES), we developed a new set of rigid instruments according to the principles of transanal endoscopic microsurgery (TEM).These instruments are long, curved, and steerable by rotating two wheels near its handle. Our success in transvaginal cholecystectomy in human with these instruments motivated us to explore the feasibility of rectosigmoid resection through the anus.

RESULTS: Twelve rectosigmoid resections, 20 stapled, and 27 hand-sutured anastomoses were performed in two experimental setups… Both groups had one anastomotic leak.

CONCLUSIONS: Transanal rectosigmoid resection is feasible with TEM technology. The unobstructed "empty pelvis" view is likely to enhance the quality of mesorectal dissection.

 

Laparoscopic colectomy and restorative proctocolectomy for familial adenomatous polyposis.
Vitellaro M, Bonfanti G, Sala P, Poiasina E, Barisella M, Signoroni S, Mancini A, Bertario L.
Surg Endosc. 2010 Dec 7. [Epub ahead of print]
PMID: 21136106 [PubMed - as supplied by publisher]

RESULTS: Of the 55 patients… Anastomotic leak was 3 (5.4%: 2 laparoscopic and 1 open)… Long-term small-bowel obstruction was 2 (3.6%). One mortality due to liver metastases occurred at 24 months.

CONCLUSIONS: Laparoscopic prophylactic treatment of Familial Adenomatous Polyposis appears to be safe and feasible and may be an appealing alternative to open surgery. If the goal of prophylactic Familial Adenomatous Polyposis surgery is to avoid cancer occurrence, laparoscopic surgery could be an important advancement.

 

Evaluation of factors affecting the difficulty of laparoscopic anterior resection for rectal cancer: "narrow pelvis" is not a contraindication.
Ogiso S, Yamaguchi T, Hata H, Fukuda M, Ikai I, Yamato T, Sakai Y.
Surg Endosc. 2010 Dec 7. [Epub ahead of print]
PMID: 21136101 [PubMed - as supplied by publisher]

CONCLUSIONS: Maximum tumor diameter, BMI, operator experience, and tumor location can be used to predict the operative time required to complete laparoscopic anterior resection with DST anastomosis for rectal cancer, with no correlations between pelvic dimensions and operative time. The difficulty of the procedure was not related to patients' pelvic dimensions, which led us to conclude that "narrow pelvis" is not a contraindication for this surgery. Based on these results, we suggest that laparoscopic anterior resection should be performed by experienced surgeons in patients with large tumors, high BMI, and/or extraperitoneal rectal cancer.

 

Transanal circular-stapled reanastomosis as a management alternative for anastomotic colonic strictures: a novel technique in the pediatric patient.
Lugo-Vicente H, Zequeira JJ, Joalex A.
Bol Asoc Med P R. 2010 Jan-Mar;102(1):56-8.
PMID: 20853576 [PubMed - indexed for MEDLINE]

ABSTRACT: A 12-year-old male patient with a recalcitrant rectal anastomotic stricture following two failed endorectal pull-through (Soave) procedures for Hirschsprung's disease was satisfactorily managed with transanal resection using a circular stapling device. This is the first reported case of a benign colonic anastomotic stricture treated transanally with a circular stapling device in a pediatric patient.

 

Anastomotic leak detection by electrolyte electrical resistance.
DeArmond DT, Cline AM, Johnson SB.
J Invest Surg. 2010 Aug;23(4):197-203.
PMID: 20690844 [PubMed - indexed for MEDLINE]

CONCLUSION: Electrical resistance change associated with electrolyte-gated leak detection is highly sensitive and specific and has the potential to be rapidly translated into clinical settings.

 

Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002).
Cairns SR, Scholefield JH, Steele RJ, Dunlop MG, Thomas HJ, Evans GD, Eaden JA, Rutter MD, Atkin WP, Saunders BP, Lucassen A, Jenkins P, Fairclough PD, Woodhouse CR; British Society of Gastroenterology; Association of Coloproctology for Great Britain and Ireland.
Gut. 2010 May;59(5):666-89. Review.
PMID: 20427401 [PubMed - indexed for MEDLINE]

ABSTRACT: The British Society of Gastroenterology (BSG) and the Association of Coloproctology for Great Britain and Ireland (ACPGBI) commissioned this update of the 2002 guidance. The aim, as before, is to provide guidance on the appropriateness, method and frequency of screening for people at moderate and high risk from colorectal cancer. This guidance provides some new recommendations for those with inflammatory bowel disease and for those at moderate risk resulting from a family history of colorectal cancer. In other areas guidance is relatively unchanged, but the recent literature was reviewed and is included where appropriate.

 

Symptomatic anastomotic leakage diagnosed after hospital discharge following low anterior resection for rectal cancer.
Matthiessen P, Lindgren R, Hallböök O, Rutegård J, Sjödahl R; Rectal Cancer Trial on Defunctioning Stoma Study Group.
Colorectal Dis. 2010 Jul;12(7 Online):e82-7. Epub 2009 Jul 7.
PMID: 19594606 [PubMed - indexed for MEDLINE]

METHOD: Patients (n = 234) undergoing low anterior resection of the rectum for cancer… who developed symptomatic anastomotic leakage diagnosed after hospital discharge (late leakage, LL; n = 18 [YS: 7.7%]) were identified.

CONCLUSION: Symptomatic anastomotic leakage diagnosed after hospital discharge following low anterior resection of the rectum for cancer is not uncommon and has an immediate clinical postoperative course which may appear uneventful.

Endo-sponge assisted treatment of anastomotic leakage following colorectal surgery.
Riss S, Stift A, Meier M, Haiden E, Grünberger T, Bergmann M.
Colorectal Dis. 2010 Jul;12(7 Online):e104-8. Epub 2009 Apr 13.
PMID: 19508536 [PubMed - indexed for MEDLINE]

CONCLUSIONS: Endo-sponge treatment can be recommended as an alternative approach to treat pelvic sepsis following anastomotic dehiscence or rectal stump insufficiency. Extended leakages should be treated by different approaches having little probability of successful healing, but can lead to discomfort for the patient. Radiochemotherapy does not cause a problem for application of the endo-sponge.


Anastomotic leakage after curative anterior resection for rectal cancer: short and long-term outcome.
Bertelsen CA, Andreasen AH, Jørgensen T, Harling H; Danish Colorectal Cancer Group.
Colorectal Dis. 2010 Jul;12(7 Online):e76-81. Epub 2009 Apr 29.
PMID: 19438879 [PubMed - indexed for MEDLINE]

CONCLUSION: Anastomotic leakage after Anterior Resection for rectal cancer increases the 30-day and long-term mortality, but Anastomotic Leakage did not increase the risk of local and distant recurrence.

 

Updated December 14, 2010