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Partial-Thickness Excision

  • Peter A. Cataldo
  • Neil J. Mortensen
Chapter

Introduction

Transanal endoscopic microsurgery (TEM) facilitates excision of lesions throughout the entire rectum. Depending upon rectal location, full-thickness rectal wall excision can result in increased potential for complications. The proximal rectum, particularly anteriorly, is located within the peritoneal cavity, and wound dehiscence can lead to intraperitoneal sepsis. In women, the vagina is immediately anterior to the distal one third of the anterior rectum, putting patients at increased risk for anovaginal fistula following full-thickness resection. In the very distal rectum, just above the dentate line sphincter musculature is at risk, and full-thickness wounds heal poorly. In all these circumstances partial-thickness, or submucosal, excision is associated with lower morbidity. If the pathologic finding is appropriate (i.e., benign disease) partial-thickness rectal wall excision is an excellent alternative in these situations.

Indications

Partial-thickness excision is...

Keywords

Rectal Wall Transanal Endoscopic Microsurgery Excision Wound Occult Malignancy Submucosal Plane 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Peter A. Cataldo
    • 1
  • Neil J. Mortensen
  1. 1.University of Vermont College of MedicineBurlingtonUSA

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