title: Novel combined approach in the management of non-healing solitary rectal ulcer syndrome - laparoscopic resection rectopexy and transanal endoscopic microsurgery.
abstract: Solitary rectal ulcer syndrome (SRUS) is an uncommon chronic disorder with a wide range of endoscopic findings, clinical presentations and characteristic histopathological features. There is no clear consensus regarding SRUS management, because of its poorly understood pathogenesis and frequent association with various pelvic floor disorders. Laparoscopic resection rectopexy and transanal endoscopic microsurgery (TEM) were used for the treatment of non-healing SRUS. The present paper reports a case of non-healing SRUS due to obstructive defecation syndrome based on combined pelvic floor disorders (rectocele, enterocele, internal rectal prolapse and dolichosigma) successfully managed by a novel combined mini-invasive approach which has never been previously reported in the literature (laparoscopic resection rectopexy and TEM). The new minimally invasive concept seems to be safe and feasible - laparoscopic resection rectopexy results in effective correction of the obstructive defecation syndrome, while TEM allows comfortable access for radical resection of a rectal ulcer.
authors.affiliation: Department of Surgery, University Hospital Ostrava, Ostrava, Czech Republic ; Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Ihnat
authors.affiliation: Department of Surgery, 2 Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
authors.forename: Lubomir
authors.initials: L
authors.lastname: Martinek
authors.affiliation: Department of Surgery, University Hospital Ostrava, Ostrava, Czech Republic ; Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Vavra
authors.affiliation: Department of Surgery, University Hospital Ostrava, Ostrava, Czech Republic ; Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Zonca
keywords: resection rectopexy; solitary rectal ulcer; transanal endoscopic microsurgery