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Simple instruments facilitating achievement of transanal total mesorectal excision in male patients

AIM: To assess the efficacy of a modified approach with transanal total mesorectal excision (taTME) using simple customized instruments in male patients with low rectal cancer. METHODS: A total of 115 male patients with low rectal cancer from December 2006 to August 2015 were retrospectively studied...

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Autores principales: Xu, Chang, Song, Hua-Yu, Han, Shao-Liang, Ni, Shi-Chang, Zhang, Hu-Xiang, Xing, Chun-Gen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569295/
https://www.ncbi.nlm.nih.gov/pubmed/28883706
http://dx.doi.org/10.3748/wjg.v23.i31.5798
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author Xu, Chang
Song, Hua-Yu
Han, Shao-Liang
Ni, Shi-Chang
Zhang, Hu-Xiang
Xing, Chun-Gen
author_facet Xu, Chang
Song, Hua-Yu
Han, Shao-Liang
Ni, Shi-Chang
Zhang, Hu-Xiang
Xing, Chun-Gen
author_sort Xu, Chang
collection PubMed
description AIM: To assess the efficacy of a modified approach with transanal total mesorectal excision (taTME) using simple customized instruments in male patients with low rectal cancer. METHODS: A total of 115 male patients with low rectal cancer from December 2006 to August 2015 were retrospectively studied. All patients had a bulky tumor (tumor diameter ≥ 40 mm). Forty-one patients (group A) underwent a classical approach of transabdominal total mesorectal excision (TME) and transanal intersphincteric resection (ISR), and the other 74 patients (group B) underwent a modified approach with transabdominal TME, transanal ISR, and taTME. Some simple instruments including modified retractors and an anal dilator with a papilionaceous fixture were used to perform taTME. The operative time, quality of mesorectal excision, circumferential resection margin, local recurrence, and postoperative survival were evaluated. RESULTS: All 115 patients had successful sphincter preservation. The operative time in group B (240 min, range: 160-330 min) was significantly shorter than that in group A (280 min, range: 200-360 min; P = 0.000). Compared with group A, more complete distal mesorectum and total mesorectum were achieved in group B (100% vs 75.6%, P = 0.000; 90.5% vs 70.7%, P = 0.008, respectively). After 46.1 ± 25.6 mo follow-up, group B had a lower local recurrence rate and higher disease-free survival rate compared with group A, but these differences were not statistically significant (5.4% vs 14.6%, P = 0.093; 79.5% vs 65.1%, P = 0.130). CONCLUSION: Retrograde taTME with simple customized instruments can achieve high-quality TME, and it might be an effective and economical alternative for male patients with bulky tumors.
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spelling pubmed-55692952017-09-07 Simple instruments facilitating achievement of transanal total mesorectal excision in male patients Xu, Chang Song, Hua-Yu Han, Shao-Liang Ni, Shi-Chang Zhang, Hu-Xiang Xing, Chun-Gen World J Gastroenterol Retrospective Study AIM: To assess the efficacy of a modified approach with transanal total mesorectal excision (taTME) using simple customized instruments in male patients with low rectal cancer. METHODS: A total of 115 male patients with low rectal cancer from December 2006 to August 2015 were retrospectively studied. All patients had a bulky tumor (tumor diameter ≥ 40 mm). Forty-one patients (group A) underwent a classical approach of transabdominal total mesorectal excision (TME) and transanal intersphincteric resection (ISR), and the other 74 patients (group B) underwent a modified approach with transabdominal TME, transanal ISR, and taTME. Some simple instruments including modified retractors and an anal dilator with a papilionaceous fixture were used to perform taTME. The operative time, quality of mesorectal excision, circumferential resection margin, local recurrence, and postoperative survival were evaluated. RESULTS: All 115 patients had successful sphincter preservation. The operative time in group B (240 min, range: 160-330 min) was significantly shorter than that in group A (280 min, range: 200-360 min; P = 0.000). Compared with group A, more complete distal mesorectum and total mesorectum were achieved in group B (100% vs 75.6%, P = 0.000; 90.5% vs 70.7%, P = 0.008, respectively). After 46.1 ± 25.6 mo follow-up, group B had a lower local recurrence rate and higher disease-free survival rate compared with group A, but these differences were not statistically significant (5.4% vs 14.6%, P = 0.093; 79.5% vs 65.1%, P = 0.130). CONCLUSION: Retrograde taTME with simple customized instruments can achieve high-quality TME, and it might be an effective and economical alternative for male patients with bulky tumors. Baishideng Publishing Group Inc 2017-08-21 2017-08-21 /pmc/articles/PMC5569295/ /pubmed/28883706 http://dx.doi.org/10.3748/wjg.v23.i31.5798 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Study
Xu, Chang
Song, Hua-Yu
Han, Shao-Liang
Ni, Shi-Chang
Zhang, Hu-Xiang
Xing, Chun-Gen
Simple instruments facilitating achievement of transanal total mesorectal excision in male patients
title Simple instruments facilitating achievement of transanal total mesorectal excision in male patients
title_full Simple instruments facilitating achievement of transanal total mesorectal excision in male patients
title_fullStr Simple instruments facilitating achievement of transanal total mesorectal excision in male patients
title_full_unstemmed Simple instruments facilitating achievement of transanal total mesorectal excision in male patients
title_short Simple instruments facilitating achievement of transanal total mesorectal excision in male patients
title_sort simple instruments facilitating achievement of transanal total mesorectal excision in male patients
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569295/
https://www.ncbi.nlm.nih.gov/pubmed/28883706
http://dx.doi.org/10.3748/wjg.v23.i31.5798
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