title: [Minimally invasive treatment of synchronous colorectal tumours].
abstract: In patients with colorectal cancers synchronous neoplastic lesions are an increasingly frequent finding at preoperative staging; 3% of the cases are other cancers while 33-35% of the synchronous lesions are villous adenomas. The treatment of most colorectal adenomas can be performed by endoscopic poplypectomy. In 5% of cases there are synchronous colorectal lesions also requiring surgical treatment. From January 1995 to June 2007 we treated 5 patients with rectal lesions by transanal endoscopic microsurgery (TEM) together with a laparoscopic colectomy for the presence of synchronous lesions at the "Clinica Chirurgica Generale e d'Urgenza" of the University of Perugia,. Surgical timing involved performing a sequential exeresis characterised by a cancer resection, followed by resection of the voluminous adenoma: TEM for rectal cancer followed by a laparoscopic right hemicolectomy with an extracorporeal anastomosis for a voluminous villous adenoma (1 patient) and laparoscopic right hemicolectomy with an extracorporeal anastomosis for cancer followed by TEM for a voluminous villous adenoma (2 patients). One patient with left colon cancer associated with a voluminous villous rectal adenoma first underwent TEM for the rectal adenoma and then a left laparoscopic hemicolectomy with an extracorporeal anastomosis in order to ease the transit of the circular mechanical stapler. Another patient with rectal and right colon adenomas first underwent TEM for a voluminous rectal sessile adenoma and later a right hemicolectomy. The use of this minimally invasive approach allowed rectum preservation and less invasive surgery.
authors.affiliation: Clinica Chirurgica Generale d'Urgenza, Università degli Studi di Perugia, Azienda Ospedaliera di Terni.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cirocchi
authors.forename: Marco
authors.initials: M
authors.lastname: Coccetta
authors.forename: Angelo
authors.initials: A
authors.lastname: De Sol
authors.forename: Umberto
authors.initials: U
authors.lastname: Morelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Spizzirri
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cattorini
authors.forename: Eriberto
authors.initials: E
authors.lastname: Farinella
authors.forename: Gianmario
authors.initials: G
authors.lastname: Giustozzi
authors.forename: Francesco
authors.initials: F
authors.lastname: Sciannameo
mesh_terms: D000236:Adenoma / Q000601:surgery*; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008866:Microsurgery