[Transanal endorectal surgery with a modified hand-made device]

ABSTRACT

Gasless transanal endoscopic microsurgery of rectum promises to offer a safe and effective option for the selective treatment of patients with rectal lesions. This study describes personal experience of using a modified hand-made device for transanal endoscopic surgery to facilitate surgical access to selected intrarectal lesions with an acceptable cost, safety and effectiveness. This descriptive cross-sectional study carried out from 2003 to 2005 at Ghaem Hospital of Mashhad University of Medical Sciences. This study was approved by the local committee of Medical Ethics. Nine patients including 4 men and 5 women with rectal polyp or tumors with low likelihood of malignancy enrolled in this study. Transanal endoscopic surgery was performed and pathological studies were done on tissue specimens. Data analyzed by SPSS. The location of the mass in the rectum ranged from 5-20 cm from anal verge, and tumors ranged in size from 2 to 7 cm. Mean age of patients was 65 years. Curative local excision performed in 7 of 9 patients [77.8%]. The complications included wound separation [n=1], massive postoperative bleeding [n=1] and temporary incontinence [n=2]. There was no mortality, either recurrence within a follow-up period of 20 months. Mean of operative time recorded 55 minutes. Two patients underwent radical operation later, because of rectal polyposis and involved tomour margin. Transanal endoscopic surgery is a safe and effective option for the selective treatment of rectal lesions. The used device lowered the expenses and simplified the system, using a hand-made special rigid cylinder