BACKGROUND The most common technique for treating benign and early malignant rectal lesions is transanal endoscopic microsurgery(TEM).Local excision is an acceptable technique for high-risk and elderly patients,but th...BACKGROUND The most common technique for treating benign and early malignant rectal lesions is transanal endoscopic microsurgery(TEM).Local excision is an acceptable technique for high-risk and elderly patients,but there are hardly any data regarding young patients.AIM To describe TEM outcomes in patients under 50 years of age.METHODS We collected demographic,clinical,and pathological data from all patients under the age of 50 years who underwent the TEM procedure at Hasharon Rabin Medical Center from January 2005 to December 2018.RESULTS During the study period,a total of 26 patients under the age of 50 years underwent TEM procedures.Their mean age was 43.3 years.Eleven(42.0%)were male.The mean operative time was 67 min,and the mean tumor size was 2.39 cm,with a mean anal verge distance of 8.50 cm.No major intraoperative or postoperative complications were recorded.The median length of stay was 2 d.Seven(26.9%)lesions were adenomas with low-grade dysplasia,four(15.4%)were high-grade dysplasia adenomas,two were T1 carcinomas(7.8%),and three were T2 carcinomas(11.5%).No residual disease was found following endoscopic polypectomy in two patients(7.8%),but four(15.4%)had other pathologies.Surgical margins were negative in all cases.Local recurrence was detected in one patient 33 mo following surgery.CONCLUSION Among young adult patients,TEM for benign rectal lesions has excellent outcomes.It may also offer a balance between the efficacy of complete oncologic resection and postoperative quality of life in the treatment of rectal cancer.In some cases,it may be considered an alternative to radical surgery.展开更多
Schwann-like adipose-derived stem cells and nerve injury:Peripheral nerve injuries(PNIs)are a common clinical problem usually as a consequence of trauma.Despite optimal surgical management,PNI has a lifelong impact on...Schwann-like adipose-derived stem cells and nerve injury:Peripheral nerve injuries(PNIs)are a common clinical problem usually as a consequence of trauma.Despite optimal surgical management,PNI has a lifelong impact on function and wellbeing of the patient.The peripheral nervous system(PNS)has regenerative capability,in contrast to the central nervous system(CNS),and is dependent on the plasticity of the peripheral glia,Schwann cells(SCs).Despite this regenerative capability,PNI recovery of sensorial and motor function is always incomplete causing pain,cold intolerance,paralysis and impairment of activities of daily living.展开更多
文摘BACKGROUND The most common technique for treating benign and early malignant rectal lesions is transanal endoscopic microsurgery(TEM).Local excision is an acceptable technique for high-risk and elderly patients,but there are hardly any data regarding young patients.AIM To describe TEM outcomes in patients under 50 years of age.METHODS We collected demographic,clinical,and pathological data from all patients under the age of 50 years who underwent the TEM procedure at Hasharon Rabin Medical Center from January 2005 to December 2018.RESULTS During the study period,a total of 26 patients under the age of 50 years underwent TEM procedures.Their mean age was 43.3 years.Eleven(42.0%)were male.The mean operative time was 67 min,and the mean tumor size was 2.39 cm,with a mean anal verge distance of 8.50 cm.No major intraoperative or postoperative complications were recorded.The median length of stay was 2 d.Seven(26.9%)lesions were adenomas with low-grade dysplasia,four(15.4%)were high-grade dysplasia adenomas,two were T1 carcinomas(7.8%),and three were T2 carcinomas(11.5%).No residual disease was found following endoscopic polypectomy in two patients(7.8%),but four(15.4%)had other pathologies.Surgical margins were negative in all cases.Local recurrence was detected in one patient 33 mo following surgery.CONCLUSION Among young adult patients,TEM for benign rectal lesions has excellent outcomes.It may also offer a balance between the efficacy of complete oncologic resection and postoperative quality of life in the treatment of rectal cancer.In some cases,it may be considered an alternative to radical surgery.
基金supported by Ateneo Sapienza Funds 2017(RM11715C7F959CA4)“Avvio Giovani”Project 2018(AR11816435A0F81D)from Ateneo Sapienza to RP.RP fellowship was also supported by CIB 2018+1 种基金AF and AJR are supported by the Hargreaves and Ball Trust,the Academy of Medical Sciences(AMS-SGCL7)by Seed Corn Funding from the Rosetrees Trust and the Stoneygate Trust(M746).
文摘Schwann-like adipose-derived stem cells and nerve injury:Peripheral nerve injuries(PNIs)are a common clinical problem usually as a consequence of trauma.Despite optimal surgical management,PNI has a lifelong impact on function and wellbeing of the patient.The peripheral nervous system(PNS)has regenerative capability,in contrast to the central nervous system(CNS),and is dependent on the plasticity of the peripheral glia,Schwann cells(SCs).Despite this regenerative capability,PNI recovery of sensorial and motor function is always incomplete causing pain,cold intolerance,paralysis and impairment of activities of daily living.
