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  1. Article ; Online: Transanal minimally invasive surgery (TAMIS) versus transanal endoscopic microsurgery (TEM): is one better than the other?

    Atallah, Sam B / Albert, Matthew R

    Surgical endoscopy

    2013  Volume 27, Issue 12, Page(s) 4750–4751

    MeSH term(s) Colorectal Surgery/education ; Humans ; Microsurgery/education ; Models, Structural ; Natural Orifice Endoscopic Surgery/education
    Keywords covid19
    Language English
    Publishing date 2013-07-27
    Publishing country Germany
    Document type Letter ; Comment
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-013-3111-4
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  2. Article ; Online: Decoding Twitter: Understanding the History, Instruments, and Techniques for Success.

    Logghe, Heather J / Boeck, Marissa A / Atallah, Sam B

    Annals of surgery

    2016  Volume 264, Issue 6, Page(s) 904–908

    Language English
    Publishing date 2016-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000001824
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  3. Article ; Online: Radiologic Evaluation of Clinically Benign Rectal Neoplasms May Not Be Necessary Before Local Excision.

    Lee, Lawrence / Arbel, Leor / Albert, Matthew R / Atallah, Sam B / Hill, James / Monson, John R T

    Diseases of the colon and rectum

    2018  Volume 61, Issue 10, Page(s) 1163–1169

    Abstract: Background: Local excision may be curative for benign and malignant rectal neoplasms. Because many early rectal cancers are discovered incidentally after local excision of clinically benign lesions, it is unclear whether preoperative imaging with ... ...

    Abstract Background: Local excision may be curative for benign and malignant rectal neoplasms. Because many early rectal cancers are discovered incidentally after local excision of clinically benign lesions, it is unclear whether preoperative imaging with transrectal ultrasound or MRI affects management.
    Objective: The purpose of this study was to determine the diagnostic characteristics and effect of preoperative imaging on the incidence of malignancy in benign rectal lesions undergoing local excision.
    Design: Prospective data from 2 institutions were included. Coarsened exact matching created a balanced cohort comparing imaging and no-imaging groups.
    Setting: The study was conducted at high-volume specialist referral hospitals.
    Patients: Adult patients undergoing local excision via transanal endoscopic surgery between 1997 and 2016 for clinically benign rectal neoplasms were included.
    Intervention: The study intervention included preoperative imaging with transrectal ultrasound and/or MRI.
    Main outcome measures: We measured the incidence of malignancy and diagnostic accuracy of preoperative imaging.
    Results: A total of 620 patients were included (272 with preoperative imaging and 348 without). There were 250 patients undergoing transrectal ultrasound, and 24 patients undergoing MRI (2 patients underwent both). Transrectal ultrasound and MRI correctly identified malignant polyps in 50% (11/22) and 44% (8/18). Overall agreement for benign versus malignant polyps between preoperative imaging and final pathology was κ = 0.30 (95% CI, 0.18-0.41) for transrectal ultrasound and 0.29 (95% CI, 0.01-0.57) for MRI. In both the overall and unmatched cohorts, the incidence of malignancy, margin involvement, and proportion of patients requiring salvage surgery was similar.
    Limitations: Data were obtained from 2 institutions with different equipment over a long time period.
    Conclusions: Preoperative imaging did not accurately identify malignancy in clinically benign rectal lesions and did not affect the incidence of malignancy, margin involvement, or proportion of patients requiring salvage surgery. Therefore, preoperative imaging may not be necessary for clinically benign lesions undergoing local excision. See Video Abstract at http://links.lww.com/DCR/A695.
    MeSH term(s) Aged ; Aged, 80 and over ; Colonic Polyps/diagnostic imaging ; Colonic Polyps/pathology ; Colonic Polyps/surgery ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging/methods ; Male ; Margins of Excision ; Middle Aged ; Neoplasm Staging ; Neoplasms/pathology ; Neoplasms/surgery ; Outcome Assessment (Health Care) ; Preoperative Care/standards ; Prospective Studies ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/epidemiology ; Rectal Neoplasms/surgery ; Rectum/diagnostic imaging ; Rectum/pathology ; Transanal Endoscopic Surgery/methods ; Ultrasonography/methods ; United States/epidemiology
    Language English
    Publishing date 2018-08-16
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0000000000001168
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  4. Article ; Online: Incisionless laparoscopic stoma construction using a 12-mm Hassan trocar.

    Atallah, Sam B / Debeche-Adams, Teresa

    The American surgeon

    2012  Volume 78, Issue 11, Page(s) E495–7

    MeSH term(s) Aged, 80 and over ; Equipment Design ; Female ; Humans ; Laparoscopes ; Laparoscopy/methods ; Surgical Instruments ; Surgical Stomas
    Language English
    Publishing date 2012-11
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
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  5. Article ; Online: Transanal minimally invasive surgery for repair of rectourethral fistula.

    Atallah, Sam B / deBeche-Adams, Teresa C / Larach, Sergio

    Diseases of the colon and rectum

    2014  Volume 57, Issue 7, Page(s) 899

    MeSH term(s) Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Rectal Fistula/surgery ; Rectum/surgery ; Urethral Diseases/surgery ; Urinary Fistula/surgery
    Language English
    Publishing date 2014-07
    Publishing country United States
    Document type Case Reports ; Journal Article ; Video-Audio Media
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0000000000000136
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  6. Article ; Online: Outcomes of Closed Versus Open Defects After Local Excision of Rectal Neoplasms: A Multi-institutional Matched Analysis.

    Lee, Lawrence / Althoff, Ashley / Edwards, Kimberley / Albert, Matthew R / Atallah, Sam B / Hunter, Iain A / Hill, James / Monson, John R T

    Diseases of the colon and rectum

    2018  Volume 61, Issue 2, Page(s) 172–178

    Abstract: Background: The management of the rectal wall defect after local excision of rectal neoplasms remains controversial, and the existing data are equivocal.: Objective: This study aimed to determine the effect of open versus closed defects on ... ...

    Abstract Background: The management of the rectal wall defect after local excision of rectal neoplasms remains controversial, and the existing data are equivocal.
    Objective: This study aimed to determine the effect of open versus closed defects on postoperative outcomes after local excision of rectal neoplasms.
    Design: Data from 3 institutions were analyzed. Propensity score matching was performed in one-to-one fashion to create a balanced cohort comparing open and closed defects.
    Settings: This study was conducted at high-volume specialist referral hospitals.
    Patients: Adult patients undergoing local excision via transanal endoscopic surgery from 2004 to 2016 were included. Patients were assigned to open- and closed-defect groups, and further stratified by full- or partial-thickness excision.
    Intervention: Closure of the rectal wall defect was performed at the surgeon's discretion.
    Main outcome measures: The primary outcome measured was the incidence of 30-day complications.
    Results: A total of 991 patients were eligible (593 full-thickness excision with 114 open and 479 closed, and 398 partial-thickness excision with 263 open and 135 closed). After matching, balanced cohorts consisting of 220 patients with full-thickness excision and 210 patients with partial-thickness excision were created. Operative time was similar for open and closed defects for both full-and partial-thickness excision. The incidence of 30-day complications was similar for open and closed defects after full- (15% vs. 12%, p = 0.432) and partial-thickness excision (7% vs 5%, p = 0.552). The total number of complications was also similar after full- or partial-thickness excision. Patients undergoing full-thickness excision with open defects had a higher incidence of clinically significant bleeding complications (9% vs 3%, p = 0.045).
    Limitations: Data were obtained from 3 institutions with different equipment and perioperative management over a long time period.
    Conclusions: There was no difference in overall complications between open and closed defects for patients undergoing local excision of rectal neoplasms, but there may be more bleeding complications in open defects after full-thickness excision. A selective approach to defect closure may be appropriate. See Video Abstract at http://links.lww.com/DCR/A470.
    MeSH term(s) Aged ; Female ; Humans ; Incidence ; Male ; Margins of Excision ; Middle Aged ; Minimally Invasive Surgical Procedures/adverse effects ; Minimally Invasive Surgical Procedures/methods ; Operative Time ; Postoperative Complications/epidemiology ; Propensity Score ; Rectal Neoplasms/epidemiology ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Rectum/abnormalities ; Rectum/pathology ; Rectum/surgery ; Transanal Endoscopic Microsurgery/adverse effects ; Transanal Endoscopic Microsurgery/methods ; Transanal Endoscopic Surgery/methods ; Treatment Outcome ; Wound Closure Techniques
    Language English
    Publishing date 2018-02
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0000000000000962
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  7. Article ; Online: Quality of Local Excision for Rectal Neoplasms Using Transanal Endoscopic Microsurgery Versus Transanal Minimally Invasive Surgery: A Multi-institutional Matched Analysis.

    Lee, Lawrence / Edwards, Kimberly / Hunter, Iain A / Hartley, John E / Atallah, Sam B / Albert, Matthew R / Hill, James / Monson, John R

    Diseases of the colon and rectum

    2017  Volume 60, Issue 9, Page(s) 928–935

    Abstract: Background: There are no data comparing the quality of local excision of rectal neoplasms using transanal endoscopic microsurgery and transanal minimally invasive surgery.: Objective: The purpose of this study was to compare the incidence of tumor ... ...

    Abstract Background: There are no data comparing the quality of local excision of rectal neoplasms using transanal endoscopic microsurgery and transanal minimally invasive surgery.
    Objective: The purpose of this study was to compare the incidence of tumor fragmentation and positive margins for patients undergoing local excision of benign and malignant rectal neoplasms using transanal endoscopic microsurgery versus transanal minimally invasive surgery.
    Design: This was a multi-institutional cohort study using coarsened exact matching.
    Settings: The study was conducted at high-volume tertiary institutions with specialist colorectal surgeons.
    Patients: Patients undergoing full-thickness local excision for benign and malignant rectal neoplasms were included.
    Interventions: Transanal endoscopic microsurgery and transanal minimally invasive surgery were the included interventions.
    Main outcome measures: The incidence of poor quality excision (composite measure including tumor fragmentation and/or positive resection margin) was measured.
    Results: The matched cohort consisted of 428 patients (247 with transanal endoscopic microsurgery and 181 with transanal minimally invasive surgery). Transanal minimally invasive surgery was associated with shorter operative time and length of stay. Poor quality excision was similar (8% vs 11%; p = 0.233). There were also no differences in peritoneal violation (3% vs 3%; p = 0.965) and postoperative complications (11% vs 9%; p = 0.477). Cumulative 5-year disease-free survival for patients undergoing transanal endoscopic microsurgery was 80% compared with 78% for patients undergoing transanal minimally invasive surgery (log rank p = 0.824). The incidence of local recurrence for patients with malignancy who did not undergo immediate salvage surgery was 7% (8/117) for transanal endoscopic microsurgery and 7% (7/94) for transanal minimally invasive surgery (p = 0.864).
    Limitations: All of the procedures were also performed at high-volume referral centers by specialist colorectal surgeons with slightly differing perioperative practices and different time periods.
    Conclusions: High-quality local excision for benign and rectal neoplasms can be equally achieved using transanal endoscopic microsurgery or transanal minimally invasive surgery. The choice of operating platform for local excisions of rectal neoplasms should be based on surgeon preference, availability, and cost. See Video Abstract at http://links.lww.com/DCR/A382.
    MeSH term(s) Aged ; Anal Canal/pathology ; Anal Canal/surgery ; Cohort Studies ; Disease-Free Survival ; Female ; Humans ; Length of Stay/statistics & numerical data ; Male ; Margins of Excision ; Middle Aged ; Minimally Invasive Surgical Procedures/adverse effects ; Minimally Invasive Surgical Procedures/methods ; Minimally Invasive Surgical Procedures/standards ; Neoplasm Staging ; Neoplasm, Residual/etiology ; Neoplasm, Residual/prevention & control ; Operative Time ; Outcome and Process Assessment (Health Care) ; Quality Assurance, Health Care ; Rectal Neoplasms/epidemiology ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Transanal Endoscopic Microsurgery/adverse effects ; Transanal Endoscopic Microsurgery/methods ; Transanal Endoscopic Microsurgery/standards ; United Kingdom/epidemiology
    Language English
    Publishing date 2017-09
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Multicenter Study
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0000000000000884
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  8. Article ; Online: Chemoradiation and Local Excision for T2N0 Rectal Cancer Offers Equivalent Overall Survival Compared to Standard Resection: a National Cancer Database Analysis.

    Lee, Lawrence / Kelly, Justin / Nassif, George J / Atallah, Sam B / Albert, Matthew R / Shridhar, Ravi / Monson, John R T

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

    2017  Volume 21, Issue 10, Page(s) 1666–1674

    Abstract: Background: Local excision (LE) alone is associated with worse survival compared to radical surgery (RS) for T2 rectal cancer, but LE with additional chemoradiation (CRT) may improve outcomes. The objective of this study was to compare combined CRT and ... ...

    Abstract Background: Local excision (LE) alone is associated with worse survival compared to radical surgery (RS) for T2 rectal cancer, but LE with additional chemoradiation (CRT) may improve outcomes. The objective of this study was to compare combined CRT and LE versus RS for T2 rectal cancer.
    Methods: The 2004-2014 National Cancer Database was queried for patients with T2N0M0 rectal cancer undergoing LE with neoadjuvant(NA-CRT + LE) or adjuvant(LE + Adj-CRT) CRT, or RS. The main outcome was 5-year overall survival (OS). Cox proportional hazards was used to determine the independent effect of treatment on OS.
    Results: A total of 4822 patients were included (4367 RS, 242 CRT + LE, 213 LE + Adj-CRT). Mean follow-up was 48.6 (SD28.5) months. There were no differences in patient characteristics, but more high-risk features in the LE + Adj-CRT group. There were no differences in 90-day mortality. Five-year OS was similar (RS 77.4% vs. CRT + LE 76.1% vs. LE + Adj-CRT 79.7%, p = 0.786). Older age, male gender, and higher Charlson score were independently associated with worse OS, whereas treatment type was not. If 90-day mortality was excluded, LE + Adj-CRT was independently associated with worse OS compared to RS.
    Conclusions: CRT with LE for T2N0M0 rectal cancer was not associated with worse OS compared to RS, and may be a viable treatment modality.
    MeSH term(s) Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/therapy ; Adult ; Aged ; Chemoradiotherapy, Adjuvant ; Databases, Factual ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Rectal Neoplasms/mortality ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy ; Rectum/surgery ; Survival Analysis
    Language English
    Publishing date 2017-08-17
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 2012365-6
    ISSN 1873-4626 ; 1934-3213 ; 1091-255X
    ISSN (online) 1873-4626 ; 1934-3213
    ISSN 1091-255X
    DOI 10.1007/s11605-017-3536-5
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  9. Article ; Online: Urethral Injury and Other Urologic Injuries During Transanal Total Mesorectal Excision: An International Collaborative Study.

    Sylla, Patricia / Knol, Joep J / D'Andrea, Anthony P / Perez, Rodrigo O / Atallah, Sam B / Penna, Marta / Hompes, Roel / Wolthuis, Albert / Rouanet, Philippe / Fingerhut, Abe

    Annals of surgery

    2019  Volume 274, Issue 2, Page(s) e115–e125

    Abstract: Objective: To identify risk factors for urethral and urologic injuries during transanal total mesorectal excision (taTME) and evaluate outcomes.: Background: Urethral injury is a rare complication of abdominoperineal resection (APR) that has not been ...

    Abstract Objective: To identify risk factors for urethral and urologic injuries during transanal total mesorectal excision (taTME) and evaluate outcomes.
    Background: Urethral injury is a rare complication of abdominoperineal resection (APR) that has not been reported during abdominal proctectomy. The Low Rectal Cancer Development Program international taTME registry recently reported a 0.8% incidence, but actual incidence and mechanisms of injury remain largely unknown.
    Methods: A retrospective analysis of taTME cases complicated by urologic injury was conducted. Patient demographics, tumor characteristics, intraoperative details, and outcomes were analyzed, along with surgeons' experience and training in taTME. Surgeons' opinion of contributing factors and best approaches to avoid injuries were evaluated.
    Results: Thirty-four urethral, 2 ureteral, and 3 bladder injuries were reported during taTME operations performed over 7 years by 32 surgical teams. Twenty injuries occurred during the teams' first 8 taTME cases ("early experience"), whereas the remainder occurred between the 12th to 101st case. Injuries resulted in a 22% conversion rate and 8% rate of unplanned APR or Hartmann procedure. At median follow-up of 27.6 months (range, 3-85), the urethral repair complication rate was 26% with a 9% rate of failed urethral repair requiring permanent urinary diversion. In patients with successful repair, 18% reported persistent urinary dysfunction.
    Conclusions: Urologic injuries result in substantial morbidity. Our survey indicated that those occurring in surgeons' early experience might best be reduced by implementation of structured taTME training and proctoring, whereas those occurring later relate to case complexity and may be avoided by more stringent case selection.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Proctectomy/adverse effects ; Rectal Neoplasms/surgery ; Retrospective Studies ; Transanal Endoscopic Surgery/adverse effects ; Urethra/injuries ; Urinary Tract/injuries
    Language English
    Publishing date 2019-09-30
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000003597
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  10. Article ; Online: Application of laser-assisted indocyanine green fluorescent angiography for the assessment of tissue perfusion of anodermal advancement flaps.

    Atallah, Sam B / Albert, Matthew R / deBeche-Adams, Teresa C / Izfar, Seema / Larach, Sergio

    Diseases of the colon and rectum

    2013  Volume 56, Issue 6, Page(s) 797

    MeSH term(s) Angiography/methods ; Graft Survival ; Humans ; Indocyanine Green ; Lasers ; Perfusion ; Surgical Flaps/blood supply
    Chemical Substances Indocyanine Green (IX6J1063HV)
    Language English
    Publishing date 2013-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0b013e31828e1b71
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