Local excision of rectal tumors

Abstract

Transanal local excision is a management option for patients with rectal tumors. An important final step in this operation is specimen orientation. A simple technique is described for specimen preparation, ideally performed by the surgeon in the operating room. This technique is recommended as the concluding step, for it can be as important as the local excision itself in regard to the determination of adequacy of resection and the need for additional treatment.

A useful technique for improving accuracy of resection margin identification by using a diagrammatic template for laryngeal excision specimens

“…Excision of the laryngeal region is a procedure most ENT surgeons do on a regular basis. However, the procedure should not be considered complete until after the specimen has been properly orientated 1 . We present a novel technique of intra‐operative specimen orientation.…”

“…A well‐recognised method is to mark the superior pole with a single suture 2 . Another described method of pinning specimens out onto a diathermy scratch‐pad has been used for rectal lesions 1 . A comparable method of utilising specimen mount cards was trialled in Newcastle to orientate breast lesion specimens in three dimensions 3…”

“…Improper preparation of the specimen can result in a difficult and confusing examination for the pathologist 1 . Following the orientation of the specimen, the pathologist can then identify which margins are too close to the malignant tissue.…”