{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T04:15:11Z","timestamp":1695528911204},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,10,9]],"date-time":"2016-10-09T00:00:00Z","timestamp":1475971200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>To establish the incidence of unsuspected malignancy in lesions excised through transanal endoscopic microsurgery (TEM) and examine the justification for full\u2010thickness excision of all lesions thought to be benign pre\u2010operatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Demographic, operative and pathology data of all patients undergoing <jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content> at a single institution were collected in a prospectively maintained database. Follow\u2010up data were collected with a focus on polyp recurrence rates and outcome in patients found to harbour malignancy. For lesions thought to be benign pre\u2010operatively, a submucosal excision was routinely performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>\n<jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content> was attempted in 156 cases between June 1999 and April 2013. Mean (standard deviation) patient age was 66.8 (2.1) years, with 111 males. Mean tumour size was 4.1 (1.6) cm, and mean height from anal verge was 10.4 (2.1) cm. In nine cases, the procedure was unable to be completed and in eight cases a deliberate full\u2010thickness excision was performed. In 139 patients with a presumed benign lesion, mean operating time was 53.4 min. A total of 17 (12.2%) were found to harbour an unsuspected malignancy. Recurrent polyp was seen in 14 (11.7%) of 122 cases of benign pathology (mean follow\u2010up 24.5 months) and was managed by endoscopic means in 10 patients. Mean length of stay was 1.2 days and complications occurred in 7% of cases. No patient with an unsuspected malignancy has developed recurrent disease (mean follow\u2010up 43 months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Submucosal <jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content> can result in low complication rates, short duration of surgery, short hospital stay and satisfactory recurrence rates when performed for presumed benign rectal tumours.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13791","type":"journal-article","created":{"date-parts":[[2016,10,13]],"date-time":"2016-10-13T07:41:44Z","timestamp":1476344504000},"page":"903-907","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Submucosal dissection has advantages over full\u2010thickness transanal endoscopic microsurgery in selected rectal lesions"],"prefix":"10.1111","volume":"87","author":[{"given":"Kiryu","family":"Yap","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Department of Surgery University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Department of Surgery University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,10,9]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"677","article-title":"A system for a transanal endoscopic rectum operation","volume":"55","author":"Buess G","year":"1984","journal-title":"Chirurg"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i33.11538"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000139"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.scrs.2013.03.006"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2013.11.005"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1463-1318.2000.00132.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2009.04859.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2007.03.005"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318190496f"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2002.02590.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1463-1318.2002.00293.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6018"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2418-x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12381"},{"key":"e_1_2_6_16_1","first-page":"A4507","article-title":"The outcome of rectal cancer after early salvage surgery following transanal endoscopic microsurgery seems promising","volume":"59","author":"Levic K","year":"2012","journal-title":"Dan. 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