The effect of endoscopic mucosal resection and transanal endoscopic microsurgery on anorectal function

2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
R.M. Barendse ◽  
J.M. Oors ◽  
E.J.R. de Graaf ◽  
W.A. Bemelman ◽  
P. Fockens ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Transanal Endoscopic Microsurgery ◽  
Anorectal Function ◽  
Mucosal Resection ◽  
Endoscopic Microsurgery

scholarly journals Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

BMC Surgery ◽  
2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Frank JC van den Broek ◽  
Eelco JR de Graaf ◽  
Marcel GW Dijkgraaf ◽  
Johannes B Reitsma ◽  
Jelle Haringsma ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Transanal Endoscopic Microsurgery ◽  
Trend Study ◽  
Mucosal Resection ◽  
Endoscopic Microsurgery

Systematic review of endoscopic mucosal resection versus transanal endoscopic microsurgery for large rectal adenomas

Endoscopy ◽  
2011 ◽  
Vol 43 (11) ◽  
pp. 949-949
Author(s):  
R. Barendse ◽  
F. van den Broek ◽  
E. Dekker ◽  
W. Bemelman ◽  
E. de Graaf ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endoscopic Mucosal Resection ◽  
Transanal Endoscopic Microsurgery ◽  
Mucosal Resection ◽  
Endoscopic Microsurgery

scholarly journals Randomised controlled trial of transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND Study)

Gut ◽  
2017 ◽  
Vol 67 (5) ◽  
pp. 837-846 ◽  
Author(s):  
Renée M Barendse ◽  
Gijsbert D Musters ◽  
Eelco J R de Graaf ◽  
Frank J C van den Broek ◽  
Esther C J Consten ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Endoscopic Mucosal Resection ◽  
Transanal Endoscopic Microsurgery ◽  
Controlled Trial ◽  
Cost Effective ◽  
High Rate ◽  
Complication Rates ◽  
Mucosal Resection ◽  
Life Years ◽  
Endoscopic Microsurgery

ObjectiveNon-randomised studies suggest that endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM), but EMR might be more cost-effective and safer. This trial compares the clinical outcome and cost-effectiveness of TEM and EMR for large rectal adenomas.DesignPatients with rectal adenomas ≥3 cm, without malignant features, were randomised (1:1) to EMR or TEM, allowing endoscopic removal of residual adenoma at 3 months. Unexpected malignancies were excluded postrandomisation. Primary outcomes were recurrence within 24 months (aiming to demonstrate non-inferiority of EMR, upper limit 10%) and the number of recurrence-free days alive and out of hospital.ResultsTwo hundred and four patients were treated in 18 university and community hospitals. Twenty-seven (13%) had unexpected cancer and were excluded from further analysis. Overall recurrence rates were 15% after EMR and 11% after TEM; statistical non-inferiority was not reached. The numbers of recurrence-free days alive and out of hospital were similar (EMR 609±209, TEM 652±188, p=0.16). Complications occurred in 18% (EMR) versus 26% (TEM) (p=0.23), with major complications occurring in 1% (EMR) versus 8% (TEM) (p=0.064). Quality-adjusted life years were equal in both groups. EMR was approximately €3000 cheaper and therefore more cost-effective.ConclusionUnder the statistical assumptions of this study, non-inferiority of EMR could not be demonstrated. However, EMR may have potential as the primary method of choice due to a tendency of lower complication rates and a better cost-effectiveness ratio. The high rate of unexpected cancers should be dealt with in further studies.

Endoscopic mucosal resection vs transanal endoscopic microsurgery for the treatment of large rectal adenomas

2012 ◽  
Vol 14 (4) ◽  
pp. e191-e196 ◽  
Author(s):  
R. M. Barendse ◽  
F. J. C. van den Broek ◽  
J. van Schooten ◽  
W. A. Bemelman ◽  
P. Fockens ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Transanal Endoscopic Microsurgery ◽  
Mucosal Resection ◽  
Endoscopic Microsurgery

Systematic review of endoscopic mucosal resection versus transanal endoscopic microsurgery for large rectal adenomas

Endoscopy ◽  
2011 ◽  
Vol 43 (11) ◽  
pp. 941-955 ◽  
Author(s):  
R. Barendse ◽  
F. van den Broek ◽  
E. Dekker ◽  
W. Bemelman ◽  
E. de Graaf ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endoscopic Mucosal Resection ◽  
Transanal Endoscopic Microsurgery ◽  
Mucosal Resection ◽  
Endoscopic Microsurgery

scholarly journals Glove Port Technique for Transanal Endoscopic Microsurgery

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Carrara Alessandro ◽  
Mangiola Daniela ◽  
Motter Michele ◽  
Tirone Andrea ◽  
Ghezzi Gianmarco ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Transanal Endoscopic Microsurgery ◽  
Cost Effective ◽  
Dentate Line ◽  
Anorectal Function ◽  
Late Complications ◽  
R0 Resection ◽  
Specialized Equipment ◽  
Endoscopic Microsurgery ◽  
Glove Port

Introduction. Despite initial enthusiasm, the use of transanal endoscopic microsurgery (TEM) is still quite limited at present because of the expense of highly specialized equipment and the complexity of the learning curve. Furthermore, some authors report a relevant, although temporary, effect on anorectal function because of the considerable anal dilatation which can even produce a rupture of the internal anal sphincter. The “glove TEM” proposes itself as an alternative to traditional TEM that could settle these problems.Materials and Methods. The technique is accurately described together with the necessary equipment to perform it. Between 2011 and 2012, we operated eight patients with this technique for rectal adenomas or early carcinomas achieving R0 resection in all cases and reporting no early or late complications during the first five months of followup.Discussion. This technique offers multiple advantages compared to the original TEM. (i) It allows the use of all available laparoscopic instruments. (ii) It gives a great manoeuvrability of the instruments in contrast to rigid rectoscope systems. (iii) Given the limited length of the device, it permits to operate on tumors closer to the dentate line. (iv) It is less traumatic to the anal sphincter. It is definitively much cheaper.Conclusions. We believe that this new technique is easy to perform, cost-effective, and less traumatic to the anal sphincter compared to traditional TEM.

Sign in / Sign up

Export Citation Format

Share Document