The Experts below are selected from a list of 99 Experts worldwide ranked by ideXlab platform
Xuan Dong Pham - One of the best experts on this subject based on the ideXlab platform.
-
TRANSANAL TOTAL MESORECTAL EXCISION OF RECTAL CANCER TREATMENT
Journal of Medicine and Pharmacy, 2019Co-Authors: Viet Hung Tran, Anh Vu Pham, Nhu Hiep Pham, Huu Thien Ho, Hai Thanh Phan, Xuan Dong PhamAbstract:Purpose: To evaluate the early results of the feasibility and safety on technology and oncologic transanal total mesorectal excision (down to up). Materils and method: Prospective study from 2012 to 2018. Patients: 23 rectum adenocarcinoma staging T ≤ 3, N ≤ 1, M0 were operated using one of two modalities Hybrid NOTES (A) and NOTES (B). Results: Twenty three patients with Rectal cancer were sucessfully in total mesorectal excision performed by Hybrid NOTES and NOTES procedures. Three cases in group NOTES had per-operative complications such as bleeding or Urethra Injury required one or two trocarts for assistance, no conversion to open surgery and no mortality. The operation time: group A (Hybrid NOTES): 190 ± 47 (120-280) mins; group B (NOTES): 258 ± 40 (190-300) mins. The hospital stay: 9 ± 2.7 (4-19) day. Conclusions: transanal total mesorectal excision (down to up) endoscopic surgery (NOTES) and Hybrid NOTES is feasible and safe.However, a study in a large number of patient and long follow-up is necessary. Key words: Mesorectum, Natural orifice transluminal endoscopic surgery (NOTES), Hybrid NOTES, rectal cancer
Todorov G - One of the best experts on this subject based on the ideXlab platform.
-
Transanal Total Mesorectal Excision - a New Approach to the Minimally Invasive Surgical Treatment of Rectal Cancer with Mid and Distal Location
2020Co-Authors: Sokolov M, W. Brunner, L. Marti, S. Maslyankov, Angelov K, Todorov GAbstract:Introduction: Transanal reversed Total Mesorectal Excision is an innovative high-tech method with an exponentially increasing use worldwide since its introduction by Antonio Lacy in 2011. The technique was developed using a single port - platform to improve the quality of the total mesorectal excision of rectal cancer with low- and middle- third localization. The distal mesorectum is processed by a transanal access in the caudo-cranial direction which facilitates its dissection with adequate visual indication of the distal margin. This technology potentially offers a more precise performance of “acute” dissection with a higher percentage of complete removal of the specimen in ablastic borders and a lower percentage of tumor involvement of circumferential resection line. This approach is applied in highly specialized centers but there are still no randomized clinical trials examining the full advantages and drawbacks of this new technology. COLOR III, which launched in late 2015, is the first large-scale study of this kind. Despite the potential benefits and enthusiasm in introducing this method, the method of implementation is relatively complex, it requires serious technical security and a long learning curve. Certain relatively new serious complications associated with this procedure, which are not observed in conventional approaches, have been observed in smaller cohorts. Iatrogenic lesion of the Urethra, Injury to the structures of lateral pelvic wall with life-threatening bleeding as well as lesions on the lower hypogastric nerves are documented complications occurring less frequently in “conventional laparoscopic” cranio-caudal TME. Introduction of this technique requires serious training programs, preparation of guidelines and monitoring of results. These requirements are the target of the scheduled in May, 2016 TaTME Congress in Amsterdam.Materials and Methods: We used surgical treatment by a reversed (transanal) single port - technique with 3D - visualization of caudo-cranial (down to up) stage of TME in 19 patients with low and middle rectal cancer operated on by the author`s team in the university tertiary center KSSG - St. Gallen, Switzerland, following the criteria of COLOR III multicenter randomized trial with reporting of intra and early postoperative results. Transabdominal laparoscopic single-port approach was used simultaneously in the abdominal stage to mobilize the left colon. All patients were discussed at the preoperative tumor-board with their data from endoscopic, histological and imaging (MRI, PET-CT scan) examinations prior to being included in the study cohort.Results: The average age of the operated patients was 68.7 with the gender distribution being - 59% men and 41% women. All patients have received preoperative radiotherapy. 17 of the patients have been postoperatively histologically confirmed, according to the quality of TME as a whole (complete), performed with intact fascia propria recti and in two patients there was partly damaged fascia. pR0 resection was performed on all of the patients . In all patients underwent protective ileostomy for 6 weeks. There were no major intraoperative complications. During the early postoperative period, the postoperative complications were as follows: Clavien-Dindo I-IIIa - 4 patients; Clavien-Dindo IIIa-IV - 0 patients.Discussion: The evolving tendency towards minimally invasive surgical approaches to rectal cancer continues to face problems such as the necessity of adequate visual exposure of the pelvis, distal ablastic rectal division, lower pelvic anastomosis as well as the appropriate for all of this technical equipment. Laparoscopic transanal total mesorectal excision was developed as an innovative alternative that offers certain advantages over the problems of conventional open and laparoscopic rectal surgery but presented its own specific problems the solution of which requires a coordinated approach at a multinational level.
Viet Hung Tran - One of the best experts on this subject based on the ideXlab platform.
-
TRANSANAL TOTAL MESORECTAL EXCISION OF RECTAL CANCER TREATMENT
Journal of Medicine and Pharmacy, 2019Co-Authors: Viet Hung Tran, Anh Vu Pham, Nhu Hiep Pham, Huu Thien Ho, Hai Thanh Phan, Xuan Dong PhamAbstract:Purpose: To evaluate the early results of the feasibility and safety on technology and oncologic transanal total mesorectal excision (down to up). Materils and method: Prospective study from 2012 to 2018. Patients: 23 rectum adenocarcinoma staging T ≤ 3, N ≤ 1, M0 were operated using one of two modalities Hybrid NOTES (A) and NOTES (B). Results: Twenty three patients with Rectal cancer were sucessfully in total mesorectal excision performed by Hybrid NOTES and NOTES procedures. Three cases in group NOTES had per-operative complications such as bleeding or Urethra Injury required one or two trocarts for assistance, no conversion to open surgery and no mortality. The operation time: group A (Hybrid NOTES): 190 ± 47 (120-280) mins; group B (NOTES): 258 ± 40 (190-300) mins. The hospital stay: 9 ± 2.7 (4-19) day. Conclusions: transanal total mesorectal excision (down to up) endoscopic surgery (NOTES) and Hybrid NOTES is feasible and safe.However, a study in a large number of patient and long follow-up is necessary. Key words: Mesorectum, Natural orifice transluminal endoscopic surgery (NOTES), Hybrid NOTES, rectal cancer
Lin-yang Ye - One of the best experts on this subject based on the ideXlab platform.
-
Modified Madigan prostatectomy
Chinese journal of surgery, 2003Co-Authors: Jun Lü, Wei Wang, Zhi-xiong Deng, Xiao-ting Huang, Yuan-li Wang, Wei-lie Hu, Hui-xu He, Lin-yang YeAbstract:OBJECTIVE: To improve Madigan prostatectomy (MPC) for a much satisfactory effect in open surgery. METHODS: A total of 52 patients with benign prostatic hyperplasia (BPH) were treated using MPC. The MPC procedure was modified by exposing anterior prostatic Urethra near the bladder neck and conjunction with cystotomy. This modified procedure preserved prostatic Urethra intact and could also deal with intracystic lesions at the same time. RESULTS: The intact of prostatic Urethra was kept completely or almost for 48 cases. The hemorrhage amount during modified procedure was a less. The mean operative time was 120 minutes. The 35 patients had been followed up for 1 - 12 months. The average Qmax was 18.9 ml/s. The cystourethrography revealed that the Urethra and bladder neck were intact in 8 patients postoperatively. Furthermore, the prostatic Urethra was obviously wider after modified MPC. CONCLUSIONS: The modified MPC can reduce the Urethra Injury and enlarge the MPC indications. The modified technique is easy to perform with little complications and much more satisfactory clinical result. The modified MPC is highly recommended.
Xu Yong - One of the best experts on this subject based on the ideXlab platform.
-
Application of sparc~(TM) sling system in treatment of female stress urinary incontinence (report of 48 cases)
China Journal of Modern Medicine, 2020Co-Authors: Xu YongAbstract:[Objective] To evaluate the application and effectiveness of sparcTM sling system opetation in the treatment of female stress urinary incontinence (SUI). [Method] 48 SUI patients' clinical data and efficacy treated by sparcTM sling system operation from January 2004 to December 2005 were analyzed retrospectively. [Results] All patients had no bladder and Urethra Injury, no retropubic hematoma, After removal of catheters, 47 patients successfully voided without incontinence, detrusor instability to various degrees developed in 8 patients and were relieved by expectant treatment. 1 suffered urination difficulty and cured by releasing tension sling. All patients were followed up for 3 to 12 months (mean 6 months), neither recurrence of SUI nor lower urinary tract obstruction was found. No graft rejection and inflammation occurred. [Conclusion] SparcTM sling system is a simple, safe, minimal and efficacious method to treat SUI.
