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Feasibility of transanal endoscopic total mesorectal excision for rectal cancer: results of a pilot study

PURPOSE: To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. METHODS: This study enrolled 12 patients with clinically node negative rectal cancer located 4–12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of sin...

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Autores principales: Oh, Jae Hwan, Park, Sung Chan, Kim, Min Jung, Park, Byung Kwan, Hyun, Jong Hee, Chang, Hee Jin, Han, Kyung Su, Sohn, Dae Kyung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Surgical Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064229/
https://www.ncbi.nlm.nih.gov/pubmed/27757396
http://dx.doi.org/10.4174/astr.2016.91.4.187
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author Oh, Jae Hwan
Park, Sung Chan
Kim, Min Jung
Park, Byung Kwan
Hyun, Jong Hee
Chang, Hee Jin
Han, Kyung Su
Sohn, Dae Kyung
author_facet Oh, Jae Hwan
Park, Sung Chan
Kim, Min Jung
Park, Byung Kwan
Hyun, Jong Hee
Chang, Hee Jin
Han, Kyung Su
Sohn, Dae Kyung
author_sort Oh, Jae Hwan
collection PubMed
description PURPOSE: To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. METHODS: This study enrolled 12 patients with clinically node negative rectal cancer located 4–12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of single port laparoscopic surgery between September 2013 and August 2014. The primary endpoint was TME quality; secondary endpoints included number of harvested lymph nodes and postoperative complications within 30 days (NCT01938027). RESULTS: The 12 patients included 7 males and 5 females, of median age 59 years and median body mass index 24.2 kg/m(2). Tumors were located on average 6.7 cm from the anal verge. Four patients (33.3%) received preoperative chemoradiotherapy. Median operating time was 195 minutes and median blood loss was 50 mL. There were no intraoperative complications and no conversions to open surgery. TME was complete or nearly complete in 11 patients (91.7%). Median distal resection and circumferential resection margins were 18.5 mm and 10 mm, respectively. Median number of harvested lymph nodes was 15. Median length of hospital stay was 9 days. There were no postoperative deaths. Six patients experienced minor postoperative complications, including urinary dysfunction in 2, transient ileus in 3, and wound abscess in 1. CONCLUSION: This pilot study showed that high-quality TME was possible in most patients without serious complications. Transanal TME for patients with rectal cancer may be feasible and safe, but further investigations are necessary to evaluate its long-term functional and oncologic outcomes and to clarify its indications.
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spelling pubmed-50642292016-10-18 Feasibility of transanal endoscopic total mesorectal excision for rectal cancer: results of a pilot study Oh, Jae Hwan Park, Sung Chan Kim, Min Jung Park, Byung Kwan Hyun, Jong Hee Chang, Hee Jin Han, Kyung Su Sohn, Dae Kyung Ann Surg Treat Res Original Article PURPOSE: To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. METHODS: This study enrolled 12 patients with clinically node negative rectal cancer located 4–12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of single port laparoscopic surgery between September 2013 and August 2014. The primary endpoint was TME quality; secondary endpoints included number of harvested lymph nodes and postoperative complications within 30 days (NCT01938027). RESULTS: The 12 patients included 7 males and 5 females, of median age 59 years and median body mass index 24.2 kg/m(2). Tumors were located on average 6.7 cm from the anal verge. Four patients (33.3%) received preoperative chemoradiotherapy. Median operating time was 195 minutes and median blood loss was 50 mL. There were no intraoperative complications and no conversions to open surgery. TME was complete or nearly complete in 11 patients (91.7%). Median distal resection and circumferential resection margins were 18.5 mm and 10 mm, respectively. Median number of harvested lymph nodes was 15. Median length of hospital stay was 9 days. There were no postoperative deaths. Six patients experienced minor postoperative complications, including urinary dysfunction in 2, transient ileus in 3, and wound abscess in 1. CONCLUSION: This pilot study showed that high-quality TME was possible in most patients without serious complications. Transanal TME for patients with rectal cancer may be feasible and safe, but further investigations are necessary to evaluate its long-term functional and oncologic outcomes and to clarify its indications. The Korean Surgical Society 2016-10 2016-09-30 /pmc/articles/PMC5064229/ /pubmed/27757396 http://dx.doi.org/10.4174/astr.2016.91.4.187 Text en Copyright © 2016, the Korean Surgical Society http://creativecommons.org/licenses/by-nc/4.0/ Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Oh, Jae Hwan
Park, Sung Chan
Kim, Min Jung
Park, Byung Kwan
Hyun, Jong Hee
Chang, Hee Jin
Han, Kyung Su
Sohn, Dae Kyung
Feasibility of transanal endoscopic total mesorectal excision for rectal cancer: results of a pilot study
title Feasibility of transanal endoscopic total mesorectal excision for rectal cancer: results of a pilot study
title_full Feasibility of transanal endoscopic total mesorectal excision for rectal cancer: results of a pilot study
title_fullStr Feasibility of transanal endoscopic total mesorectal excision for rectal cancer: results of a pilot study
title_full_unstemmed Feasibility of transanal endoscopic total mesorectal excision for rectal cancer: results of a pilot study
title_short Feasibility of transanal endoscopic total mesorectal excision for rectal cancer: results of a pilot study
title_sort feasibility of transanal endoscopic total mesorectal excision for rectal cancer: results of a pilot study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064229/
https://www.ncbi.nlm.nih.gov/pubmed/27757396
http://dx.doi.org/10.4174/astr.2016.91.4.187
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