TY  - BOOK
AU  - Ayscue, Jennifer M
AU  - Chhitwal, Nandita
AU  - Coralic, Jasna
AU  - FitzGerald, James F
AU  - Kumar, Anjali S
AU  - Smith, Lee E
AU  - Stahl, Thomas J
TI  - Transanal endoscopic microsurgery: safe for midrectal lesions in morbidly obese patients
SN  - 0002-9610
KW  - *Anal Canal
KW  - *Endoscopy, Gastrointestinal
KW  - *Microsurgery/mt [Methods]
KW  - *Obesity, Morbid/co [Complications]
KW  - *Rectal Neoplasms/pa [Pathology]
KW  - *Rectal Neoplasms/su [Surgery]
KW  - Aged
KW  - Ambulatory Surgical Procedures
KW  - Body Mass Index
KW  - Case-Control Studies
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Proctoscopes
KW  - Rectal Neoplasms/co [Complications]
KW  - Retrospective Studies
KW  - MedStar Washington Hospital Center
KW  - Surgery/Colorectal Surgery
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - BACKGROUND: Transanal endoscopic microsurgery is a safe option for proximal rectal tumors in morbidly obese patients for whom transabdominal pelvic dissection often is fraught with morbidity; CONCLUSIONS: Transanal endoscopic microsurgery in morbidly obese patients is a safe, feasible, and a viable alternative to low anterior resection. Copyright  2012 Elsevier Inc. All rights reserved; METHODS: From a database of 318 patients who underwent transanal endoscopic microsurgery, we report a retrospective case-control study of 9 patients with a body mass index range of 35 to 66 with sessile rectal lesions 6 to 15 cm from the anal verge who underwent transanal endoscopic microsurgery. Case subjects were compared with 15 controls and matched for age, tumor type, and level of tumor. The average body mass index of controls was 30 (P < .001). By using t test analysis, perioperative outcomes (surgical time, blood loss, and hospital length of stay) and postoperative complications were compared; RESULTS: Sessile tumors were located 7 to 11 cm from the anal verge with a diameter of 1 to 4 cm. Patient and tumor factors such as age, distal tumor margin from anal verge, and tumor diameter were not significantly different between case subjects and controls. Surgical blood loss, surgical time, and hospital length of stay were not significantly different between the 2 groups. One complication occurred among the cases. No complications occurred in the control group. All patients had complete surgical resections with negative margins
UR  - http://dx.doi.org/10.1016/j.amjsurg.2011.11.011
ER  -