scholarly journals Neoadjuvant concurrent chemoradiotherapy followed by transanal total mesorectal excision assisted by single-port laparoscopic surgery for low-lying rectal adenocarcinoma: a single center study

2020 ◽  
Author(s):  
Yen-Jung Lu ◽  
Chien-Hsin Chen ◽  
En-Kwang Lin ◽  
Szu-Yuan Wu
Keyword(s):  
Laparoscopic Surgery ◽  
Total Mesorectal Excision ◽  
Single Port ◽  
Rectal Adenocarcinoma ◽  
Neoadjuvant Chemoradiotherapy ◽  
Morbidity Rate ◽  
Transanal Total Mesorectal Excision ◽  
Distal Margin ◽  
Mesorectal Excision ◽  
The Mean

Abstract Purpose: To assess the feasibility and short-term outcomes of neoadjuvant chemoradiotherapy (CCRT) followed by transanal total mesorectal excision assisted by single-port laparoscopic surgery (TaTME-SPLS) for low-lying rectal adenocarcinoma.Methods and materials: A total of 23 patients with clinical stage II-III low-lying (from anal verge 0-8 cm) rectal adenocarcinoma who underwent neoadjuvant CCRT followed by TaTME-SPLS consecutively from December 2015 to December 2018, were enrolled into our study. Chi-squared testing and Student’s t testing were used to make parametric comparisons, and Fisher’s exact test or the Mann–Whitney U-test were used to make nonparametric comparisons.Results: Conversion rate in patients who underwent neoadjuvant CCRT followed by TaTME-SPLS was only 4%. The mean operation time was 366 minutes and the inter-sphincter resection (ISR) was done for 14 patients (60%). The mean number of lymph nodes harvested were 15. There was no surgical mortality, but the 30-day morbidity rate was 21% (5 patients were Clavien-Dindo I-II). Pathological complete response was 21.74% with 100% organ preservation and 100% clear distal margin after neoadjuvant CCRT followed by TaTME-SPLS. Conclusion: Neoadjuvant CCRT followed by TaTME-SPLS can be a safe and an effective sphincter-preserving procedure with acceptable morbidity rate for Asian patients with low-lying rectal adenocarcinoma.

scholarly journals Neoadjuvant concurrent chemoradiotherapy followed by transanal total mesorectal excision assisted by single-port laparoscopic surgery for low-lying rectal adenocarcinoma: a single center study

2020 ◽  
Author(s):  
Yen-Jung Lu ◽  
Chien-Hsin Chen ◽  
En-Kwang Lin ◽  
Szu-Yuan Wu
Keyword(s):  
Laparoscopic Surgery ◽  
Total Mesorectal Excision ◽  
Single Port ◽  
Rectal Adenocarcinoma ◽  
Neoadjuvant Chemoradiotherapy ◽  
Morbidity Rate ◽  
Transanal Total Mesorectal Excision ◽  
Distal Margin ◽  
Mesorectal Excision ◽  
The Mean

Abstract Purpose To assess the feasibility and short-term outcomes of neoadjuvant chemoradiotherapy (CCRT) followed by transanal total mesorectal excision assisted by single-port laparoscopic surgery (TaTME-SPLS) for low-lying rectal adenocarcinoma. Methods and materials: A total of 23 patients with clinical stage II-III low-lying (from anal verge 0–8 cm) rectal adenocarcinoma who underwent neoadjuvant CCRT followed by TaTME-SPLS consecutively from December 2015 to December 2018, were enrolled into our study. Chi-squared testing and Student’s t testing were used to make parametric comparisons, and Fisher’s exact test or the Mann–Whitney U-test were used to make nonparametric comparisons. Results Conversion rate in patients who underwent neoadjuvant CCRT followed by TaTME-SPLS was only 4%. The mean operation time was 366 minutes and the inter-sphincter resection (ISR) was done for 14 patients (60%). The mean number of lymph nodes harvested were 15. There was no surgical mortality, but the 30-day morbidity rate was 21% (5 patients were Clavien-Dindo I-II). Pathological complete response was 21.74% with 100% organ preservation and 100% clear distal margin after neoadjuvant CCRT followed by TaTME-SPLS. Conclusion Neoadjuvant CCRT followed by TaTME-SPLS can be a safe and an effective sphincter-preserving procedure with acceptable morbidity rate for Asian patients with low-lying rectal adenocarcinoma.

scholarly journals Neoadjuvant concurrent chemoradiotherapy followed by transanal total mesorectal excision assisted by single-port laparoscopic surgery for low-lying rectal adenocarcinoma: a single center study

2020 ◽  
Author(s):  
Yen-Jung Lu ◽  
Chien-Hsin Chen ◽  
En-Kwang Lin ◽  
Szu-Yuan Wu
Keyword(s):  
Laparoscopic Surgery ◽  
Total Mesorectal Excision ◽  
Single Port ◽  
Rectal Adenocarcinoma ◽  
Neoadjuvant Chemoradiotherapy ◽  
Operation Time ◽  
Transanal Total Mesorectal Excision ◽  
Distal Margin ◽  
Mesorectal Excision ◽  
The Mean

Abstract Purpose: To assess the feasibility and short-term outcomes of neoadjuvant chemoradiotherapy (CCRT) followed by transanal total mesorectal excision assisted by single-port laparoscopic surgery (TaTME-SPLS) for low-lying rectal adenocarcinoma.Methods and materials: A total of 23 patients with clinical stage II-III low-lying (from anal verge 0-8 cm) rectal adenocarcinoma who underwent neoadjuvant CCRT followed by TaTME-SPLS consecutively from December 2015 to December 2018, were enrolled into our study. Chi-squared testing and Student’s t testing were used to make parametric comparisons, and Fisher’s exact test or the Mann–Whitney U-test were used to make nonparametric comparisons.Results: Conversion rate in patients who underwent neoadjuvant CCRT followed by TaTME-SPLS was only 4%. The mean operation time was 366 minutes and the inter-sphincter resection (ISR) was done for 14 patients (60%). The mean number of lymph nodes harvested were 15. There was no surgical mortality, but the 30-day morbidity rate was 21% (5 patients were Clavien-Dindo I-II). Pathological complete response was 21.74% with 100% organ preservation and 100% clear distal margin after neoadjuvant CCRT followed by TaTME-SPLS. Conclusion: TaTME-SPLS would be highly successful in lymph node negative and low T stage of low-lying rectal cancer patients who had pathological complete remission or high percentage of partial remission after neoadjuvant CCRT.

scholarly journals Glove single-port laparoscopy-assisted transanal total mesorectal excision for low rectal cancer: a preliminary report

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Wanglin Li ◽  
Boye Dong ◽  
Baifu Peng ◽  
Jiabao Lu ◽  
Zixin Wu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Hospital Stay ◽  
Single Port ◽  
Low Rectal Cancer ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Single Port Laparoscopy ◽  
The Mean

Abstract Purpose Glove single-port laparoscopy-assisted transanal total mesorectal excision (TaTME) has been successfully carried out in our medical center. The purpose of this study is to evaluate the feasibility of this emerging operation. Methods This technique was performed by self-made glove single-port laparoscopic platform to radically resect low rectal cancer. Short-term postoperative results, including complications, length of hospital stay, and follow-up results were collected and analyzed statistically. Results There are five consecutive patients (three males, two females) who underwent this surgery and included in this study. The mean distance from the tumor to the anal verge was 4.8 cm (range 4.0–6.0). The surgery was completed in all cases, and the rectal tumor was removed successfully without conversion; circumferential margins of all the excised specimens were negative. The mean time of operation was 338.00 min (range 280–400). The average number of lymph node dissection was 12.20. The average postoperative hospital stay was 8.60 days. During the follow-up (14.80 ± 1.92 months), all preventive ileostomies were successfully closed in about 3 months after the surgery, all patients had satisfactory anal function, and no tumor recurrence was found. Conclusion Glove single-port laparoscopy-assisted TaTME has a significant effect in specific patients with low rectal cancer, with rapid recovery and high safety. Prospective randomized studies involving more case counts and long-term follow-up results, especially oncologic outcomes, are needed to validate this technique.

scholarly journals Single-Access Laparoscopic Rectal Surgery Is Technically Feasible

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Siripong Sirikurnpiboon ◽  
Paiboon Jivapaisarnpong
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Total Mesorectal Excision ◽  
Perioperative Complications ◽  
Rectal Surgery ◽  
Anal Canal Cancer ◽  
Mesorectal Excision ◽  
Single Access ◽  
Laparoscopic Rectal Surgery ◽  
The Mean

Introduction. Single-access laparoscopic surgery (SALS) has been successfully introduced for colectomy surgery; however, for mid to low rectum procedures such as total mesorectal excision, it can be technically complicated. In this study, we introduced a single-access technique for rectum cancer operations without the use of other instruments.Aims. To show the short-term results of single-access laparoscopic rectal surgery in terms of pathologic results and immediate complications.Settings and Design. Prospective study.Materials and Methods. We selected middle rectum to anal canal cancer patients to undergo single-access laparoscopic rectal resection for rectal cancer. All patients had total mesorectal excisions. An umbilical incision was made for the insertion of a single multichannel port, and a mesocolic window was created to identify the inferior mesenteric artery and vein. Total mesorectal excision was performed. There were no perioperative complications. The mean operative time was 269 minutes; the median hospital stay was 7 days; the mean wound size was 5.5 cm; the median number of harvested lymph nodes was 15; and all patients had intact mesorectal capsules.Statistical Analysis Used. Mean, minimum–maximum.Conclusion. Single-access laparoscopic surgery for rectal cancer is feasible while oncologic principles and patient safety are maintained.

Defining the learning curve for transanal total mesorectal excision for rectal adenocarcinoma

2018 ◽  
Vol 34 (4) ◽  
pp. 1534-1542 ◽  
Author(s):  
Lawrence Lee ◽  
Justin Kelly ◽  
George J. Nassif ◽  
Teresa C. deBeche-Adams ◽  
Matthew R. Albert ◽  
...  
Keyword(s):  
Learning Curve ◽  
Total Mesorectal Excision ◽  
Rectal Adenocarcinoma ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision
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