این کنگره علمی توسط جامعه پزشکان داخلی ایران برگزار خواهد شد. هدف اصلی این کنگره و کنفرانس های علمی آن ایجاد فضایی علمی جهت تبادل اطلاعات بین متخصصین مختلف داخلی ایران در رشته های متفاوت طب داخلی میباشد.
در این کنگره علمی سعی بر این است که آخرین دستاوردها و تکنولوژیهای رایج در زمینه طب داخلی ارائه شود و اطلاعات علمی و کاربردی مفیدی از یافتههای اخیر طب داخلی در اختیار شرکت کنندگان قرار گیرد. در این راستا، سخنرانیهای متعددی توسط متخصصین برجسته داخلی و خارجی در زمینه طب داخلی من جمله لاپاروسکوپی ایراد خواهد شد. همچنین دورههای فشرده تخصصی، جلسات بحث و گفتگو و ارائههای ویدیویی نیز از برنامههای دیگر این کنفرانس علمی آموزشی میباشد.
دکتر شهرام نظری بعنوان یکی از متخصصین برجسته جراحی گوارش و لاپاروسکوپی - آندوسکوپی اینترونشنال در این کنگره شرکت فعال داشتنه و در تعامل با دیگر متخصصین از سراسر ایران، از پیشرفتهای روز در زمینه طب داخلی و جراحی اطلاع حاصل میکنند.
ایشان در تاریخ 1392/2/24 ارایه مقاله و فیلم ویدیویی تحت عنوان
Endoluminal Rectal Surgery
We are on a journey from ``Here to There``.
(Hope or Hype)
خواهند داشت.
Shahram.Nazari, MD1
(1)Department of Surgery, Erfan Hospital, Tehran, Iran
Abstract
Background: Piecemeal resection of colorectal neoplasms is associated with a higher risk of recurrent or residual tumors. Transanal endoscopic operation (TEO) is a minimally invasive alternative to conventional transanal / abdominal surgical excisions, enabling complete local excision of selected benign or malignant rectal tumors. Adoption of TEO for colorectal neoplasm is continuing. This study aimed to determine the surgical and oncologic results for rectal tumors excised by TEO.
Methods: All consecutive patients with benign or malignant rectal tumors treated with TEO methods are included.
Results: Preliminary results of our experience with TEO on patients with rectal tumors are reported. The median operating time was 55 min. All the lesions except one could be radically excised. For this patient abdominoperineal resection was performed. No intraoperative complications occurred. Postoperative complications occurred for one patient due to hemorrhage. The median hospital stay was 3 days.
Conclusions: TEO using standard laparoscopic instruments with a two-dimensional view is feasible and provides results comparable with those associated with conventional transanal surgical methods. The TEO procedure is a safe and appropriate surgical treatment option for benign rectal tumors. The TEO procedure offers reduced morbidity, faster recovery and equivalent oncologic outcome. With strict patient selection, it is oncologically safe for early-stage rectal carcinomas.
Keywords:Transanal endoscopic microsurgery, TEO, Rectal tumor.
Shahram.Nazari, MD1
(1)Department of Surgery, Erfan Hospital, Tehran, Iran
INTRODUCTION:
Although surgery within the lumen of the gut has been performed for many years, this has traditionally involved a laparotomy and enterotomy. Intraluminal surgery began with the advent of endoscopy. With the advances in flexible endoscopy, surgeons and gastroenterologists have been able to perform therapeutic procedures with instruments introduced through the working channel of flexible endoscopes. These procedures, however, have been mainly limited to technically minor ones, such as injection and cautery of bleeding ulcers and resection of polyps and small mucosal lesion. After the development of percutaneous gastrostomy (PEG) by Ponsky and Gandevev, but before the mini-invasive laparoscopic revolution, endoscopic foregut excision of early gastric cancer became commonplace in Japan. The benefit of endoscopic mucosal resection (EMR) for mucosal malignancies has been significant, with the cure rate for T1 lesions being as high as 98%. After the advent of laparoscopic cholecystectomy, gastric access ports were developed with the intent to allow creation of an endo-organ surgery for a variety of intraluminal gastric porocedures. Ohashi first developed laparoscopic intragastric surgery (LIGS) using an open technique through which minilaparotomy ballon trocars were introduced for access. Intraluminal rectal surgery was first introduced by Beuss for benign and early malignant rectal lesions (Trans-Endoscopic Mucosectomy, ``TEM``). More recently, laparoscopic surgeons have been able to isolate the lumen of hollow organs as a separate working space and develop instrumentation and technique specifically for intraluminal surgery. Endoscopic endoluminal surgery has limitations; and its failure results in conventional open or laparoscopic interventions with increased morbidity. Laparoscopy-assisted intraluminal surgery is a novel alternative to open or laparoscopic surgery for a failed endoscopic endoluminal technique, minimizing the associated complications. Endoscopic resection of early cancers is restricted by the limited view of the endoscope, insufficient number of instrument channels, and inability to have adequate margins of resection without risking perforation. These cancers potentially can be treated by laparoscopy-assisted intraluminal surgery without resorting to major resection. This procedure is relatively easy to perform and oncologically effective. We present our experience in laparoscopy-assisted endoluminal surgery.