Tomá Skřička, Jan Smetka, Vladimir Sihotský
Minimally invasive polypectomy of the rectum. Our complications
Background: The greatest challenge in patients with rectal polyps or with the initial stages of rectal cancer is the minimally invasive approach, respecting all the oncosurgical principles.
Patients and methods: The diagnostic and therapeutic work-up of patients with rectal polyps, treated by means of minimally invasive principles, is reviewed in the period of 1995-2000.
We analysed results of 43 patients operated by parasacral, transsphincteric and classic transanal approach and 91 patients operated by Buess transanal microsurgery device.
Results: In the first group, there have been 3 rectocutaneous fistulas and twice there was the necessity of the creation of the stoma. Till now, no patients died and we had to reoperate 2 times. In the second group, there were 3 tumour dissemination and death, 2 laparotomies according to the bleeding and 1 Miles procedure due to tumour recurrence.
Conclusions: The last decade has seen a trend toward minimally invasive surgery in the rectal polyps, too. However, the final decision in the individual case depends on the equipement of the department, the skill of the operating team and the stage of the polyps and tumours.