Total mesorectal excision TME first described in by Heald et al. Laparoscopic procedure for rectal cancer has shown short- and long-term oncological efficacies similar to open surgery 2 - 4 , and it has the advantages of early recovery of bowel function, less blood loss and postoperative pain with shorter hospitalization 4 - 6. TME performed laparoscopically has been carried out worldwide 7 - 9. Laparoscopic radical low resection of low rectal cancer with sphincter preservation has been one of the most difficult procedures in colorectal surgery.
Women frequently describe symptoms of anorectal disease to their gynecologist. These symptoms may coexist with pregnancy or pelvic floor disorders, or may occur independently. The most common symptoms are pain and bleeding with defecation, but may also include itching, drainage, and fullness from a mass e. These are most often attributed to benign disorders e. Diet and lifestyle changes can ameliorate symptoms from fissures and hemorrhoids, but the patient with persistent symptoms or a more complicated entity may require evaluation and possibly surgical intervention by a specialist.
Laparoscopic sphincter-saving surgery for low rectal cancer through marker meeting approach
Most patients with anal pain or irritation present to their physicians complaining of hemorrhoids. Anal fissures , proctalgia fugax, levator ani syndrome, and pruritis ani are common causes of anorectal pain and irritation. The primary care clinician can diagnose and manage these diseases with confidence, as most patients have uncomplicated cases that respond to simple lifestyle changes and routine medications. An anal fissure is a longitudinal tear or ulcerated area in the distal anal canal, usually in the posterior or anterior midline and usually extending from the level of the dentate line out to the anal verge.
Anal stenosis is a rare but serious complication of anorectal surgery, most commonly seen after hemorrhoidectomy. Anal stenosis represents a technical challenge in terms of surgical management. A Medline search of studies relevant to the management of anal stenosis was undertaken. The etiology, pathophysiology and classification of anal stenosis were reviewed. An overview of surgical and non-surgical therapeutic options was developed.