scholarly journals Clinical Status and Future Prospects of Transanal Total Mesorectal Excision

2022 ◽  
Vol 11 ◽  
Author(s):  
Zichao Guo ◽  
Xiaopin Ji ◽  
Shaodong Wang ◽  
Yaqi Zhang ◽  
Kun Liu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Resection Margin ◽  
Clinical Status ◽  
Radical Resection ◽  
Low Rectal Cancer ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Promising Alternative ◽  
Novel Approach

Low rectal cancer has always posed surgical challenges to gastrointestinal surgeons. Transanal total mesorectal excision (taTME) is a novel approach to radical resection for low rectal cancer. Compared with conventional laparoscopic TME (laTME), taTME is relevant to the benefits of better vision of the mesorectal plane, feasibility of operating in a narrow pelvis, and exact definition of distal resection margin, which may lead to a higher possibility of free circumferential resection margin, better quality of TME specimen, and lower conversion rate. Although there are concerns about its long-term oncological outcomes and complex learning curve, taTME is a promising alternative for rectal cancer. In this review, we discuss the application status and prospects of taTME.

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.

Transanal total mesorectal excision: pathological results of 186 patients with mid and low rectal cancer

2017 ◽  
Vol 32 (5) ◽  
pp. 2442-2447 ◽  
Author(s):  
F. Borja de Lacy ◽  
Jacqueline J. E. M. van Laarhoven ◽  
Romina Pena ◽  
María Clara Arroyave ◽  
Raquel Bravo ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Low Rectal Cancer ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision

Transanal Total Mesorectal Excision in Mid-Low Rectal Cancer

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ziwei Zeng ◽  
Zhihang Liu ◽  
Liang Huang ◽  
Huashan Liu ◽  
Haiqing Jie ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Low Rectal Cancer ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision

Short-term outcomes of minimally invasive transanal total mesorectal excision for rectal cancer

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Văn Minh Tuấn Trần ◽  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Resection Margin ◽  
Case Series ◽  
R0 Resection ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Hospital Patients ◽  
Surgical Duration ◽  
Cancer Laparoscopy

Abstract Introduction: The aim of study was to evaluate the safety and feasibility of transanal total mesorectal excision (TaTME) for middle and low rectal cancer at Binh Dan Hospital. Patients and methods: Case series of all rectal cancer patients who underwent TaTME from January 2019 to July 2020 enrolled. Results: There were 21 patients (17 men and 4 women). The median age of patients was 58 years. The average surgical duration was 264 minutes [210 - 480]. The average blood loss was 168 ml [100 - 210]. The average hospitalization duration was 9.42 days [8 - 16]. There were 2 cases of complication as anastomotic leakage (9.5%) that responded well with conservative treatment. The ratio of R0 resection margin was 100%. There were two cases of positive postoperative circular resection margin (CRM) accounting for 9.5%. The average number of harvested lymph node were 12.34 [9 - 22]. Conclusions: TaTME could be performed safely with good oncological results for rectal cancer. This surgery has advantages for patients with narrow pelvis or obesity. Key word: Rectal cancer, laparoscopy, Transanal Total Mesorectal Excision (TaTME). Tóm tắt Đặt vấn đề: Mục tiêu của nghiên cứu nhằm khảo sát kết quả sớm của phẫu thuật nội soi (PTNS) cắt toàn bộ mạc treo trực tràng qua ngã hậu môn trong điều trị ung thư trực tràng (UTTT). Đối tượng và phương pháp nghiên cứu: Báo cáo loạt ca. Tất cả người bệnh (NB) UTTT được phẫu thuật bằng kỹ thuật cắt toàn bộ mạc treo trực tràng với PTNS qua ngã hậu môn từ tháng 1/2019 đến tháng 7/2020 tại Bệnh viện Bình Dân. Kết quả: Tổng số 21 Bệnh nhân (BN) (17 nam và 4 nữ) được thực hiện kỹ thuật này. Tuổi trung bình của BN là 58 tuổi. Thời gian phẫu thuật trung bình là 264 phút (210 - 480 phút). Lượng máu mất trung bình 168 ml (100 - 210 ml). Thời gian nằm viện trung bình là 9,42 ngày ( 8 - 16 ngày). Có 2 trường hợp xì miệng nối (9,5%) và được điều trị bảo tồn. Tỉ lệ bờ mặt cắt đạt được R0 là 100%. Có 2 trường hợp CRM (+) sau mổ (9,5%). Số lượng hạch nạo vét được trung bình là 12,34 hạch (9 - 22 hạch). Kết luận: PTNS cắt toàn bộ mạc treo trực tràng qua ngã hậu môn có thể thực hiện an toàn với kết quả tốt về mặt ung thư học. Phẫu thuật đặc biệt có lợi cho các BN có khung chậu hẹp hay béo phì. Từ khóa: Ung thư trực tràng, phẫu thuật nội soi, cắt toàn bộ mạc treo trực tràng ngã hậu môn.

Our experience with transanal total mesorectal excision (TaTME) procedures in middle and distal rectal tumors

2020 ◽  
Vol 99 (3) ◽  
pp. 124-130
Keyword(s):  
Rectal Cancer ◽  
Postoperative Complications ◽  
Total Mesorectal Excision ◽  
Resection Margin ◽  
Transanal Total Mesorectal Excision ◽  
Rectal Tumors ◽  
Mesorectal Excision ◽  
Permanent Colostomy ◽  
Conversion To Open Surgery ◽  
Distal Localization

Introduction: Transanal total mesorectal excision (TaTME) is a relatively new approach in surgical treatment of rectal cancer. There are no clear indications when to choose this strategy. It is a technically demanding procedure for the surgeon with a long learning curve, which should also be taken into account in evaluation of this method. The results of both oncological and postoperative complications must be properly evaluated to explore the benefit of TaTME. The aim of this study is to assess the potential benefit of TaTME compared to other alternatives in middle and distal rectal tumors. Methods: Retrospective evaluation of patients undergoing TaTME procedure performed by one team of surgeons between October 2014 and June 2019. The authors analyzed demographic indicators of the group of patients, tumor characteristics, specimen quality, early postoperative complications and the possibility of stoma reversal. Results: A total of 93 patients underwent TaTME procedure for middle and distal rectal cancer. Mean BMI was 27.6 (4.8). T3 or T4 tumor was found in 73 (78.5%) patients, 68 (73.1%) patients had positive lymph nodes and 12 (12.9%) patients were treated for synchronous metastatic rectal cancer. Neoadjuvant therapy was used in 80 (86%) patients. Conversion to open laparotomy was necessary in one case (1%). Stapled anastomosis was performed in 37 (39.7%) cases, handsewn in 56 (60.2%). A positive circumferential resection margin (CRM) was found in 10 (10.7%) cases. Distal resection margin (DRM) was positive in 3 (3.2%) patients. Pathological analysis showed a complete mesorectum in 18 patients (19.4%), nearly complete in 39 (41.9%) and an incomplete mesorectum in 36 (38.7%). Complications in the first 30 days after primary surgery were observed in 38 (40.8%) patients, mainly for anastomotic leak (19 patients, 20.4%). Reoperation was required in 7 (7.5%) patients. Permanent colostomy had to be performed in 4 (4.3%) cases. No patient died after surgery. Conclusion: In a selected group of patients it is possible to perform resection using this approach with acceptable postoperative morbidity and quality of the specimen. We used TaTME procedure in patients expected to have difficult TME due to obesity, size and distal localization of tumor. The incidence of conversion to open surgery was very low. Further studies for long term oncological outcomes are needed.

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