Safety and Feasibility of Transanal Endoscopic Surgery for Diffuse Cavernous Hemangioma of the Rectum

Author:

Zeng Ziwei123ORCID,Wu Xianrui123,Chen Junji123ORCID,Luo Shuangling123,Hou Yujie123ORCID,Kang Liang123ORCID

Affiliation:

1. Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

2. Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

3. Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

Abstract

Purpose. To evaluate the safety and feasibility of transanal endoscopic surgery for diffuse cavernous hemangioma of the rectum (DCHR). Methods. All DCHR patients who underwent transanal endoscopic surgery in our hospital between January 2014 and June 2018 were reviewed. Results. A total of 7 patients with a diagnosis of DCHR underwent transanal endoscopic surgery during the study period. Four patients (57.1%) were male, with a mean age at surgery of 34.5±7.7 years, and three patients (42.9%) were female, with a mean age at surgery of 29.9±3.8 years. Recurrent painless rectal bleeding was the main symptom in all patients. The mean age was 32 years old (range 21-54 years). The median duration of symptoms was 10 years (range 1 month-50 years). The level of hemoglobin at admission ranged from 59.0 to 148.0 g/l (mean 106.6 g/l), and the level of mean corpuscular volume (MCV) ranged from 75.1 fl to 93.5 fl (mean 83.7 fl). Colonoscopy, computed tomography (CT), and magnetic resonance imaging (MRI) were important in the diagnosis of DCHR because of their high positive rates and accurate features. All of the lesions are between the anal canal and the descending colon. Two patients could be found with some enlarged serpentine vessels in the cervix, vagina, or corpus cavernosum by MRI. After admission, all the patients underwent transanal endoscopic surgery and four patients had simultaneous loop ileostomy. The mean operative time was 278 min (range 168-400 min). The median amount of intraoperative blood loss was 50 ml (range 10-300 ml). The mean distance from anal verge to anastomosis was 2.2±0.2cm. The anastomosis was fashioned with a stapler in two patients (28.6%). There were no intraoperative and postoperative complications. All the patients continued to recover well from the surgery, and nobody needed postoperative blood transfusions. Conclusions. The specific diagnosis rate of DCHR is low. Preoperative MRI and CT examination can make a definitive diagnosis and determine the extent of the lesions. DCHR is mostly restricted to the rectum, sigmoid colon, anal wall, and mesorectum. The best treatment for DCHR is complete lesion resection. It is safe and feasible to treat DCHR using transanal endoscopic surgery. Moreover, transanal endoscopic surgery might have a huge potential when used to treat other rectal diseases.

Funder

Sun Yat-sen University

Publisher

Hindawi Limited

Subject

Gastroenterology,Hepatology

Cited by 9 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3