ArticleSurgical endoscopy2017
The surgical defect after transanal endoscopic microsurgery: open versus closed management.
Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Bridging the gap: a systematic literature review and meta-analysis on the management of rectal wall defect after transanal excision.Techniques in coloproctology · 2026Pooled it
- Should the rectal defect be sutured following TEMS/TAMIS carried out for neoplastic rectal lesions? A meta-analysis.Annals of the Royal College of Surgeons of England · 2020Pooled it
- Should the rectal defect be closed following transanal local excision of rectal tumors? A systematic review and meta-analysis.Techniques in coloproctology · 2017Pooled it
- Randomized clinical trial on the use of a colon-occlusion device to assist rectal washout.Surgical endoscopy · 2021Trial
- Intermittent double-layer closure for full-thickness defect after super minimally invasive stepwise resection of early rectal cancer.Endoscopy · 2025Article
- Assessment and Techniques for Endoscopic Closure.Clinics in colon and rectal surgery · 2024Review
- Robotic Transanal Minimally Invasive Surgery for Rectal Polyps.Clinics in colon and rectal surgery · 2024Review
- Endoscopic adventitial dissection of a rectal GI stromal cell tumor.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2023Article
- Transanal full-thickness excision for rectal neoplasm: is it advisable to leave the defect open?Langenbeck's archives of surgery · 2023Article
- Robotic transanal minimally invasive surgery: a single institutional experience.Updates in surgery · 2022Article
- Complex Procedures in Transanal Endoscopic Microsurgery: Intraperitoneal Entry, Ultra Large Rectal Tumors, High Lesions, and Resection in the Anal Canal.Clinics in colon and rectal surgery · 2022Review
- Long-term outcomes of transanal endoscopic microsurgery for the treatment of rectal neuroendocrine tumors.BMC surgery · 2022Article
- Predictors of rectal adenoma recurrence following transanal endoscopic surgery: a retrospective cohort study.Surgical endoscopy · 2020Article
- Perforation in the peritoneal cavity during transanal endoscopic microsurgery for rectal tumors: a real surgical complication with a challenging prognosis?Surgical endoscopy · 2019Observational
- Assessing the safety and outcomes of repeat transanal endoscopic microsurgery.Surgical endoscopy · 2019Article
- Morbidity after transanal endoscopic microsurgery: risk factors for postoperative complications and the design of a 1-day surgery program.Surgical endoscopy · 2019Observational
- Peritoneal perforation during transanal endoscopic microsurgery is not associated with significant short-term complications.Surgical endoscopy · 2019Article
- Transanal endoscopic micro-surgery in elderly and very elderly patients: a safe option? Observational study with prospective data collection.Surgical endoscopy · 2019Observational
- Salvage TME following TEM: a possible indication for TaTME.Techniques in coloproctology · 2018Article
- Analysis of the therapeutic effect of transanal endoscopic microsurgery on large rectal adenoma.Journal of minimal access surgeryArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo determine whether closure of the defect created during full thickness excision of a rectal lesion with transanal endoscopic microsurgery (TEM) leads to fewer complications when compared to leaving the defect unsutured.
methodsThis is a single-center cohort study using a prospectively maintained database. All patients ≥18 years old treated with full thickness TEM with no compromise of the peritoneal cavity were included. Two cohorts were established: patients with the defect sutured and patients with the defect left open. Demographic, operative, and pathologic data were compared. The main outcome analyzed was early (<30 day postoperative) complications, including bleeding that required investigation and readmission, infection, and reoperation.
resultsBetween 2007 and 2014, data for all patients treated with TEM have been maintained in the St. Paul's Hospital TEM database. Overall, 236 patients had the TEM defect sutured (TEM-S) and 105 patients had the defect left open (TEM-O). There were no differences between the groups in patient age, gender, tumor size or underlying tumor histology. There was no difference in OR time between the groups, but the most experienced TEM surgeon performed significantly more of the TEM-S procedures (61 vs. 39 %, p < 0.01). There were 40 postoperative complications, affecting 11.7 % of the cohort. The complication rate was higher in the TEM-O group (8.4 vs. 19.0 %, p = 0.03). There was no statistically significant difference in bleeding complications (4.7 vs. 7.6 %, p = 0.27) or infections (2.1 vs. 6.7 %, p = 0.05). Readmissions were less common in the TEM-S group (4.7 vs 12.4 %, p = 0.01).
conclusionThe St. Paul's Hospital TEM experience suggests that while it is safe to leave rectal defects open when a robust mesorectal fat layer is present, there appears to be fewer postoperative complications when the defect is sutured closed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.