Ayermin Vargas Salgueiro, MD1, Fernando Leal Hernandez, MD1, Ulises Barraza Reyes, MD1, Luis Leal Del Rosal, MD, FACS, FRCSC2. 1Christus Muguerza, 2UNIMECID
Colorectal cancer is one of the leading cause of dead ando one of the most common cancers of the GI tract.
Increasing detection of early stage colorectal cancers have demanded development of minimally invasive procedures like endoscopic mucosal resection and for tumors non amenable for endoscopic therapy, transanal endoscopic microsurgery is an alternative to a more radical resection for appropriately selected tumors, besides it is superior to ablative therapies that does not provide specimen for histopathology.
We present the resection of two cases of flat lesions detected by colonoscopy located en the middle and distal thirds of the rectum diagnosed as villus polyp with high grade dysplasia that could not be resected by colonoscopy. Both of them were located at 5 and 6 cm from the anal verge.
Transanal endoscopic microsurgery was performed.
Technique. A lone star retractor and gel point device were used un order to establish pneumorectum. Both flat polyps were found in middle and distal rectal wall, using a combination of electrosurgery and advanced surgical device, circunferenctial and full thickness rectal wall resection of sessile polyps were achieved. Histopathology showed hidden adenocarcinoma in one of cases. Patients showed uneventful recovery and discharged home the day after the procedure. Transanal microsurgery is an alternative to a more radical resection in selected rectal tumors, that are non amenable by endoscopic (colonoscopy) resection or submucosal disection because of the size of the polyp and the closeness to the anus.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94713
Program Number: V177
Presentation Session: Video Loop Day 1
Presentation Type: VideoLoop