D'Ambrosio G

Anal function after endoluminal locoregional resection by transanal endoscopic microsurgery and radiotherapy for rectal cancer.

In patients with rectal cancer, surgery and chemoradiotherapy may affect anal sphincter function. Few studies have evaluated anorectal function after neoadjuvant chemoradiotherapy (n‐CRT) and/or transanal endoscopic microsurgery (TEM). The aim of this study was to evaluate the effects of n‐CRT and TEM on anorectal function.

Use of Fluorescence Angiography for the Identification of Point of Transection in Colorectal Surgery

Celiac artery compression syndrome (Dunbar syndrome) is a rare disorder characterized by chronic, recurrent abdominal pain related to compression of the celiac artery by the median arcuate ligament. It usually presents with symptoms of abdominal pain, weight loss, and an abdominal bruit. Diagnosis is usually confirmed with imaging such as CT angiography, MRI, ultrasound, and arteriography. Surgery is currently the only treatment option and involves releasing the ligament. Methods: We present three cases of Dunbar syndrome treated by laparoscopic decompression. There were 2 males and 1 female at the age of 39, 44 and 47 years respectively. The disease has manifested with postprandial epigastric pain, weight loss and abdominal bruit, nausea, diarrhea, vomiting, and delayed gastric emptying. For surgery we used 4 troacars: two 10 mm in the umbilicus and in the left mesogastrium, two 5 mm in the epigastrium and in the right mesogastrium. After the ports placement and the examination of the abdominal cavity, the gastrohepatic ligament has been transsected to facilitate the identification of the right crus of the diaphragm. The oesophagus was dissected cranially to the oesophageal hiatus. The stomach was retracted laterally and caudally, exposing the anterior surface of the aorta. The left gastric artery was then identified. Following the superior aspect of the left gastric artery, the coeliac trunk was located. The median arcuate ligament, was divided, along with the surrounding neural coeliac plexus, until the coeliac trunk was completely exposed from the aorta to its primary branches. Results: There were no intraand postoperative complications. The blood loss was minimal. The period of hospital stay was 4 days in all 3 cases. Conclusion: Laparoscopic decompression is an effective treatment for Dunbar syndrome and can provide immediate symptomatic relief. It requires good manual laparoscopic surgical skills. P002 Abdominal Cavity and Abdominal Wall

Modified sentinel lymph node technique combined with Endoluminal Loco-Regional Resection for the treatment of rectal tumors: a fourteen year experience

After endoluminal loco‐regional resection (ELRR) by transanal endoscopic microsurgey (TEM) the N parameter may remain undefined. Nucleotide‐guided mesorectal excision (NGME) improves the lymph node harvest. The aim of the present study is to evaluate the long‐term oncological results after ELRR with NGME.