{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T18:06:31Z","timestamp":1750788391814},"reference-count":11,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,9,18]],"date-time":"2013-09-18T00:00:00Z","timestamp":1379462400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Following subtotal colectomy, the retained rectal stump is a potential source of morbidity. Although restorative ileal pouch\u2010anal anastomosis is the gold standard for ulcerative colitis, up to 14% of patients will opt for a permanent ileostomy and undergo completion proctectomy, traditionally by an abdomino\u2010perineal approach, which itself carries significant morbidity. We describe a new technique of perineal proctectomy using transanal endoscopic microsurgery (<jats:styled-content style=\"fixed-case\">TEMS<\/jats:styled-content>) equipment. To our knowledge, this technique has not previously been described in the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Twelve patients, mean (SD) age 66 (\u00b113) years, underwent <jats:styled-content style=\"fixed-case\">TEMS<\/jats:styled-content> proctectomy, performed by a single surgeon between January 2007 and October 2011. Excision began with an intersphincteric dissection following which the <jats:styled-content style=\"fixed-case\">TEMS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">WOLF<\/jats:styled-content>) proctoscope was inserted and close rectal dissection was performed, entering the peritoneal cavity (if the top of the stump was intraperitoneal). Following perineal extraction of the specimen, the external sphincter and skin were closed with an absorbable suture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine patients had inflammatory bowel disease, two had neoplasia and one had intractable radiation proctitis. The mean (SD) rectal stump length was 17.8 (\u00b16.1) cm and the peritoneal cavity was entered in nine patients, with no small\u2010bowel injury. The median postoperative hospital stay was 5.5\u00a0days. In four patients there was delayed healing of the perineal wound. There was no perioperative mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">TEMS<\/jats:styled-content> perineal proctectomy is a novel, but safe, technique that may avoid the need for a traditional abdominoperineal approach in selected patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12316","type":"journal-article","created":{"date-parts":[[2013,9,6]],"date-time":"2013-09-06T15:37:48Z","timestamp":1378481868000},"update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Transanal endoscopic microsurgery: a new technique for completion proctectomy"],"prefix":"10.1111","volume":"15","author":[{"given":"C.","family":"Liyanage","sequence":"first","affiliation":[{"name":"St Richards Hospital Chichester West Sussex UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Ramwell","sequence":"additional","affiliation":[{"name":"St Richards Hospital Chichester West Sussex UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. J.","family":"Harris","sequence":"additional","affiliation":[{"name":"St Richards Hospital Chichester West Sussex UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. F.","family":"Levy","sequence":"additional","affiliation":[{"name":"St Richards Hospital Chichester West Sussex UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. N. L.","family":"Simson","sequence":"additional","affiliation":[{"name":"St Richards Hospital Chichester West Sussex UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,9,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1997.02783.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-006-0127-4"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01224.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-991032"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1007\/s11605-011-1692-6","article-title":"Robotic\u2010 assisted proctectomy for inflammatory bowel disease: a case\u2010matched comparison of laparoscopic and robotic technique","volume":"16","author":"Miller AT","journal-title":"J Gastrointest Surg"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800640611"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02553614"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02553795"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0917-0"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0804-8"},{"key":"e_1_2_6_12_1","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1177\/1553350609359516","article-title":"Natural orifice proctectomy using a transanal endoscopic microsurgical technique in a porcine model","volume":"17","author":"Trunzo JA","journal-title":"Surg Innov"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.12316","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.12316","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T08:05:09Z","timestamp":1696320309000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.12316"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,9]]},"references-count":11,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2013,9]]}},"alternative-id":["10.1111\/codi.12316"],"URL":"https:\/\/doi.org\/10.1111\/codi.12316","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,9]]},"assertion":[{"value":"2013-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-03-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-09-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}