Minimal invasive surgery in the local treatment of XXXX .

@entity1 @entity548 @entity5 @entity189 @entity260 @entity177 @entity652 @entity204
At the Surgical Department of the University of Cologne, a system has been developed for transanal endoscopic surgery, which allows all the conventional surgical techniques within the rectal cavity. The clinical and long-term results regarding local excision of broad based @entity652 and small (< 4 cm) @entity189 of the rectum were the subject of the study. The main indication was the removal of sessile @entity652 . Early @entity189 with favourable histological grading (Grade 1 and 2) and staging (Mason I and II) were also suitable for endorectal therapeutical approach. @entity5 can be removed endoscopically in one session, but the authors performed local excisions of these @entity5 only in cases where the @entity1 was unwilling to undergo extensive surgery or due to medical reasons. Nevertheless several @entity189 were removed locally. Most of the histological findings of the subsequent radical operations (rectum resection, rectum extirpation) revealed that the @entity189 had already been totally removed. During the period July 1983 to December 1992, the techniques have been employed on 313 @entity1 in 348 cases. Early @entity260 consisted of intraperitoneal perforations (five cases); rectovaginal fistulae (four cases); @entity548 (four cases), @entity204 due to @entity177 (two cases). All the complications occurred within the first three years of the learning phase. The recurrence rate of @entity652 amounted to 5%. The technique allows accurate endoscopic microsurgical excision of @entity652 and @entity5 with minimal morbidity and excellent presentation of specimens for complete histological analysis. Open invasive surgery can thus be avoided.
