Local Recurrence After Pure NOTES Transanal Total Mesorectal Excision for Early Rectal Cancer

2022 ◽  
Author(s):  
Haipeng Meng ◽  
Longyi Chen ◽  
Ruichao Geng ◽  
Fan Yang ◽  
Rui Wang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Total Mesorectal Excision ◽  
Transanal Total Mesorectal Excision ◽  
Early Rectal Cancer ◽  
Mesorectal Excision

Statistical, Clinical, Methodological Evaluation of Local Recurrence Following Transanal Total Mesorectal Excision for Rectal Cancer

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Hans H. Wasmuth ◽  
Mahir Gachabayov ◽  
Les Bokey ◽  
Abe Fingerhut ◽  
Guy R. Orangio ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Total Mesorectal Excision ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Methodological Evaluation

Local Recurrence After Transanal Total Mesorectal Excision for Rectal Cancer

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sapho Xenia Roodbeen ◽  
Antonino Spinelli ◽  
Willem A. Bemelman ◽  
Francesca Di Candido ◽  
Maylis Cardepont ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Total Mesorectal Excision ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision

scholarly journals EARLY RECTAL CANCER: LOCAL EXCISION OR TOTAL MESORECTAL EXCISION?

2018 ◽  
pp. 42-48 ◽  
Author(s):  
A. V. Semenov ◽  
E. S. Savicheva ◽  
D. E. Popov ◽  
S. V. Vasiliev
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Total Mesorectal Excision ◽  
Preoperative Staging ◽  
Early Rectal Cancer ◽  
Mesorectal Excision ◽  
Free Survival ◽  
Prospective Group ◽  
Oncological Results

AIM of this study was to improve treatment outcomes for early rectal cancer; to assess the accuracy of endorectal ultrasound (ERUS) in preoperative staging of early rectal cancer. MATERIAL AND METHODS. A total of 42 patients of the main prospective group with early rectal cancer underwent transanal local excision (LE). In control retrospective group 39 patients underwent radical resection with total mesorectal excision (TME). Operation time, perioperative, hospital stay duration long-term oncological results (overall and local recurrence-free survival, cancer-free survival, distant metastasis rate) were analyzed.. Comparison of ERUS preoperative staging for prospective group and pathological staging was performed to identify the accuracy of ERUS. RESULTS. Median follow-up for prospective group was 41 (from 10 to 60) months. In comparison with TME, LE was associated with fewer morbid (4,8 % vs 17,9 %, p=0,04). There was no hospital mortality in both groups. The accuracy of ERUS was 88,1 % for Tis and 78,6% for T1. There was no significant statistical difference in 1-year and 3-year in oncological outcomes between groups (p=1,0). There was one local recurrence (2,6%) in 6 months after LE in a patient with pT1sm3 who had previously refused surgery. This patient underwent TME. There was no detected distant metastasis in both groups. The 3-year overall survival was 100 % for LE and 97,4 % for TME. The 3-year cancer-specific survival was 100 % in both groups. CONCLUSIONS. LE has advantages over TME in short-term results; long-term oncological results after LE are comparable with TME. ERUS has a good diagnostic effectiveness in preoperative staging of early rectal cancer.

scholarly journals Association of Transanal Total Mesorectal Excision With Local Recurrence of Rectal Cancer

2021 ◽  
Vol 4 (2) ◽  
pp. e2036330
Author(s):  
Antonio Caycedo-Marulanda ◽  
Lawrence Lee ◽  
Sami A. Chadi ◽  
Chris P. Verschoor ◽  
Jordan Crosina ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Total Mesorectal Excision ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Recurrence Of Rectal Cancer

scholarly journals Rate of local recurrence in a cohort of 125 patients treated by transanal total mesorectal excision due to rectal cancer

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
P Gioia ◽  
S Gloor ◽  
R Troller ◽  
M Adamina
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Total Mesorectal Excision ◽  
Operating Time ◽  
Disease Free Survival ◽  
Low Rectal Cancer ◽  
Perioperative Outcomes ◽  
Transanal Total Mesorectal Excision ◽  
Distal Margin ◽  
Mesorectal Excision

Abstract Objective Transanal total mesorectal excision (taTME) is an alternative to conventional TME owing to its reported superior ability to achieve clear resection margins in low rectal cancers. Yet, nationwide Norwegian data claimed a 12-month local recurrence rate of up to 10%, a three-fold increase compared to conventional TME, questioning the oncological safety of taTME. Methods Consecutive patients with low rectal cancer treated by taTME were prospectively included. Patients who required a partial mesorectal excision were excluded. Perioperative outcomes were reported as median and interquartile range (IQR). Data were independently audited and certified. Results 125 patients (88 men : 37 women) with a low rectal cancer (7 cm to anal verge, IQR 5-9) underwent a taTME. Age and body mass index were 65 years (IQR 56-76) and 26 kg/m2 (IQR 23-29). 87 (70%) patients had neoadjuvant radiochemotherapy. Surgery time was 357 minutes (IQR 303-435), including an ileostomy in all patients. 1 patient (0.8%) required a conversion to laparotomy. Performing taTME in a 2-team technique saved 94 minutes or 19% operating time (p < 0.005, t-test one-team (n = 52, 420 minutes, IQR 349-494) vs. 2-team (n = 73, 326 minutes, IQR 285-372). 30-day morbidity amounted to 36% minor complications (Dindo Clavien I-II) and 25% major complications (Dindo Clavien III-V), including 11 anastomotic leaks (9%) and 3 reoperations (3%). Most of the leaks could be managed endoscopically and the ileostomy reversed at last. Median length of hospital stay was 10 days (IQR 8-14). Median follow-up was 45 months (IQR 25-67; range 13-95). Dissection of the mesorectum was excellent (Quirke 1 incomplete mesorectal excision rate: 1.6%) with 100% clear margins (distal margin 16mm, IQR 10-30; circumferential margin 10mm, IQR 5-15). Median T stage was 3 (IQR 2-3). 24 patients had positive lymphnodes (median 27, IQR 21-38). Local recurrence occurred in 7 (6%) patients and development of metachronous metastasis was present in 36 (29%) patients. This led to a 5-year disease-free survival of 56% and a 5-year overall survival of 86%. Conclusion Transanal total mesorectal excision allows good surgical and oncologic quality to the expenses of a reasonable surgery time and morbidity.

Wasmuth HH, Færden AE, Myklebust TÅ, et al (2020) Transanal total mesorectal excision for rectal cancer has been suspended in Norway. Br J Surg 107:121–30

2020 ◽  
Vol 14 (3) ◽  
pp. 155-158
Author(s):  
M. Aubert ◽  
Y. Panis
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Cancer Du Rectum ◽  
Prise En Charge ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Récidive Locale ◽  
Kaplan Meier ◽  
Cancers Colorectaux ◽  
Technique Chirurgicale

Contexte : L’exérèse totale du mésorectum par voie transanale (TaTME) pour la prise en charge du cancer du rectum est récemment apparue comme alternative à l’exérèse totale du mésorectum par voie abdominale. Cependant, certaines inquiétudes à propos des résultats oncologiques de cette technique chirurgicale ont émergé. Le but de cette étude était d’évaluer le taux de récidives locales après TaTME. Les objectifs secondaires s’intéressaient à la mortalité postopératoire, au taux de fistule anastomotique et au taux de stomie définitive. Méthodes : Les données de tous les patients opérés par TaTME ont été rapportées et comparées aux données issues des registres nationaux norvégiens de cancers colorectaux (NCCR) et de chirurgie gastro-intestinale (NoRGast). Les taux de récidive locale étaient estimés selon Kaplan-Meier. Résultats : En Norvège, 157 patients ont été opérés par TaTME pour un cancer du rectum entre octobre 2014 et octobre 2018. Trois des sept centres hospitaliers participants ont abandonné la réalisation de cette intervention après cinq procédures. Le taux de récidive locale était de 12 sur 157 patients (7,6 %) ; huit récidives locales étaient multifocales ou étendues. Le taux de récidive locale après un suivi de à 2,4 ans était estimé à 11,6 % (IC 95 % : [6,6‒19,9]) après TaTME contre 2,4 % (IC 95 % : [1,4‒4,4]) dans le registre NCCR (p < 0,001). Le hasard ratio était estimé à 6,71 (IC 95 % : [2,94‒15,32]). Le taux de fistule anastomotique nécessitant une réintervention était de 8,4 % dans le groupe TaTME contre 4,5 % dans le registre NoRGast (p = 0,047). Cinquante-six patients (35,7 %) étaient porteurs d’une stomie à la fin du suivi, dont 39 (24,8 %) étaient définitives. Conclusion : Le taux de fistule anastomotique était plus élevé après TaTME en comparaison aux données des registres nationaux norvégiens. Le taux de récidive locale ainsi que les caractéristiques de cette récidive après TaTME étaient défavorables.

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