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Combined laparoscopic and transanal total mesorectal excision for rectal cancer: Initial experience and early results
INTRODUCTION: Incomplete specimens resulting in residual mesorectum in the patient and an increased risk of local recurrence remains a problem. We have introduced transanal-total mesorectal excision (Ta-TME) in our department to potentially overcome this problem due to more direct access to the lowe...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363116/ https://www.ncbi.nlm.nih.gov/pubmed/28281474 http://dx.doi.org/10.4103/0972-9941.195586 |
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author | Thomsen, Morten Holt Ovesen, Henrik Eriksen, Jens Ravn |
author_facet | Thomsen, Morten Holt Ovesen, Henrik Eriksen, Jens Ravn |
author_sort | Thomsen, Morten Holt |
collection | PubMed |
description | INTRODUCTION: Incomplete specimens resulting in residual mesorectum in the patient and an increased risk of local recurrence remains a problem. We have introduced transanal-total mesorectal excision (Ta-TME) in our department to potentially overcome this problem due to more direct access to the lower pelvis in patients undergoing TME for rectal cancer and this article presents our initial experience with the new procedure. MATERIALS AND METHODS: Patients with a T1-T3 mid or low rectal cancer eligible for TME or intersphincteric abdominoperineal excision were selected for a combined transanal and transabdominal laparoscopic resection. The primary aim of the study was to evaluate the feasibility and efficacy of the method with a special focus on the quality of the specimen. RESULTS: During a 9-month period, 11 patients were operated with this technique. All procedures resulted in complete or nearly complete specimen. We did, however, find the procedure technically demanding and experienced several complications with three anastomotic leaks (all with preserved intestinal continuity) and a urethral lesion. CONCLUSION: Ta-TME is feasible and might be the answer to obtaining good quality specimens and overcome some of the technical difficulties that can be encountered in the obese narrow male pelvis. The procedure however is technically demanding. |
format | Online Article Text |
id | pubmed-5363116 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-53631162017-04-12 Combined laparoscopic and transanal total mesorectal excision for rectal cancer: Initial experience and early results Thomsen, Morten Holt Ovesen, Henrik Eriksen, Jens Ravn J Minim Access Surg Original Article INTRODUCTION: Incomplete specimens resulting in residual mesorectum in the patient and an increased risk of local recurrence remains a problem. We have introduced transanal-total mesorectal excision (Ta-TME) in our department to potentially overcome this problem due to more direct access to the lower pelvis in patients undergoing TME for rectal cancer and this article presents our initial experience with the new procedure. MATERIALS AND METHODS: Patients with a T1-T3 mid or low rectal cancer eligible for TME or intersphincteric abdominoperineal excision were selected for a combined transanal and transabdominal laparoscopic resection. The primary aim of the study was to evaluate the feasibility and efficacy of the method with a special focus on the quality of the specimen. RESULTS: During a 9-month period, 11 patients were operated with this technique. All procedures resulted in complete or nearly complete specimen. We did, however, find the procedure technically demanding and experienced several complications with three anastomotic leaks (all with preserved intestinal continuity) and a urethral lesion. CONCLUSION: Ta-TME is feasible and might be the answer to obtaining good quality specimens and overcome some of the technical difficulties that can be encountered in the obese narrow male pelvis. The procedure however is technically demanding. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5363116/ /pubmed/28281474 http://dx.doi.org/10.4103/0972-9941.195586 Text en Copyright: © 2017 Journal of Minimal Access Surgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Thomsen, Morten Holt Ovesen, Henrik Eriksen, Jens Ravn Combined laparoscopic and transanal total mesorectal excision for rectal cancer: Initial experience and early results |
title | Combined laparoscopic and transanal total mesorectal excision for rectal cancer: Initial experience and early results |
title_full | Combined laparoscopic and transanal total mesorectal excision for rectal cancer: Initial experience and early results |
title_fullStr | Combined laparoscopic and transanal total mesorectal excision for rectal cancer: Initial experience and early results |
title_full_unstemmed | Combined laparoscopic and transanal total mesorectal excision for rectal cancer: Initial experience and early results |
title_short | Combined laparoscopic and transanal total mesorectal excision for rectal cancer: Initial experience and early results |
title_sort | combined laparoscopic and transanal total mesorectal excision for rectal cancer: initial experience and early results |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363116/ https://www.ncbi.nlm.nih.gov/pubmed/28281474 http://dx.doi.org/10.4103/0972-9941.195586 |
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