Rectal cancer treatment by transanal total mesorectal excision: Results in 100 consecutive patients

Publication date: Available online 6 November 2019Source: Cirugía Española (English Edition)Author(s): Vicente Simó, Jorge Arredondo, Cristina Hernán, Luís Miguel Jiménez, Benedetto Ielpo, Jesús Fernández, Amaya Villafañe, Enrique PastorAbstractIntroductionThe aim of this study is to describe and evaluate our clinical short-term surgical results of laparoscopic transanal total mesorectal excision.MethodsAnalysis of 100 consecutive patients with mid and lower rectal cancer who underwent transanal total mesorectal excision from November 2013 to September 2018. Main outcomes described are operative data, morbidities, mortality and quality of the specimen. A comparative analysis was done between gender and simultaneous versus non simultaneous abdominal-perineal surgery.ResultsMean patient age was 67 years (56–75), and 67% were male. On MRI, 50% were stage T3 tumors, and 52% had positive nodes. Mean distance of the tumor from anal verge was 4.9 ± 1.3 cm. A total of 58% underwent neoadjuvant treatment. Mean operative time was 262 ± 40.7 min; it was shorter in females (P 
Source: Cirugia Espanola - Category: Surgery Source Type: research

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Conclusions. Patients' characteristics cannot be changed, but several steps were used to avoid routine PI creation. The present protocol could be a valuable option to avoid PI in selected patients. Further studies with a wider sample size, and defined criteria to stratify the patients based on the risk to develop AL, are required. PMID: 31789117 [PubMed - as supplied by publisher]
Source: Surgical Innovation - Category: Surgery Authors: Tags: Surg Innov Source Type: research
AbstractAbdomino-perineal resection (APR) for rectal cancer is challenging, due to the difficult exposure of the surgical field. Many investigations proved worst results in terms of circumferential resection margin (CRM) involvement compared to rectal anterior resection (RAR) with total mesorectal excision (TME). Extralevator abdomino-perineal excision (ELAPE) improved oncologic outcomes, but is burdened by important limitations (positioning, wound closure). Applying the concept of transanal minimally invasive surgery (TAMIS) and the experience in transanal TME (TaTME) to the perineal phase of APR could overcome these limi...
Source: Updates in Surgery - Category: Surgery Source Type: research
ConclusionIndications for taTME at experienced centers have expanded to include complex reoperative cases, local recurrences, metastatic cancer, and tumors with threatened CRM or IAS with evidence of post-treatment tumor regression. In the latter cases, taTME achieves good short-term outcomes and may facilitate R0 resection.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
AbstractBackgroundGuidelines for rectal cancer treatment differ in Japan, Europe, and the United States. Neoadjuvant chemoradiotherapy (CRT) has been used to control lateral lymph nodes (LLNs) in the West. The usefulness of LLN dissection (LLND) has been discussed in Japan, and a randomized study stated the possible advantage of local control. However, it is still unclear whether adding LLND to CRT is beneficial.MethodsTo investigate the effectiveness of LLND on rectal cancer patients who underwent neoadjuvant CRT, we retrospectively collected magnetic resonance images (MRIs) in a cohort of 1500 patients with cStage II/III...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: Based on this nationwide database study, and after multivariate and propensity score-matched analyses, there was no increased risk of positive circumferential resection margin after laparoscopic vs open rectal resection. See Video Abstract at http://links.lww.com/DCR/A996. MARGEN DE RESECCIÓN CIRCUNFERENCIAL DESPUÉS DE LA RESECCIÓN RECTAL LAPAROSCÓPICA Y ABIERTA: UN ESTUDIO DE COHORTE DE PUNTUACIÓN DE PROPENSIÓN A NIVEL NACIONAL ANTECEDENTES: Estudios recientes sugieren mejores resultados oncológicos después de la resección rectal abierta ver...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original contributions: Colorectal Cancer Source Type: research
CONCLUSIONS: Robotic approach does not decrease complications in elderly population and conversion is similar in these age groups. So we should not rule out robotic surgery in elderly patients, although we must select each case with a multidisciplinary approach. PMID: 31506905 [PubMed - as supplied by publisher]
Source: Aging Clinical and Experimental Research - Category: Geriatrics Authors: Tags: Aging Clin Exp Res Source Type: research
CONCLUSION: The surgical technique described here, consisting of component separation and mesh at loop ileostomy reversal, is effective for repairing parastomal hernia. PMID: 31476794 [PubMed - as supplied by publisher]
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
CONCLUSION: Patients with laparoscopic LAR for rectal cancer who have experienced neoadjuvant therapy and chemotherapy, due to the thickening of the intestinal wall, the anastomosis nail is easy to fall off, more likely to have AL, and even the anastomotic is completely detachment. The use of transanal drainage tube with negative pressure flushing might avoid patients who with AL undergoing reoperation. PMID: 31431416 [PubMed - as supplied by publisher]
Source: Asian Journal of Surgery - Category: Surgery Authors: Tags: Asian J Surg Source Type: research
Villafañe A, Pastor E Abstract INTRODUCTION: The aim of this study is to describe and evaluate our clinical short-term surgical results of laparoscopic transanal total mesorectal excision. METHODS: Analysis of 100 consecutive patients with mid and lower rectal cancer who underwent transanal total mesorectal excision from November 2013 to September 2018. Main outcomes described are operative data, morbidities, mortality and quality of the specimen. A comparative analysis was done between gender and simultaneous vs. non simultaneous abdominal-perineal surgery. RESULTS: Mean patient age was 67 years...
Source: Cirugia eEspanola - Category: Surgery Authors: Tags: Cir Esp Source Type: research
AbstractThe aim of our study was to compare long term outcomes of robotic and laparoscopic sphincter-saving total mesorectal excision (TME) in male patients with mid-low rectal cancer (RC) after neoadjuvant chemoradiotherapy (NCRT). The study was conducted as a retrospective review of a prospectively maintained database, and we analyzed 14 robotic and 65 laparoscopic sphincter-saving TME (R-TME and L-TME, respectively) performed by one surgeon between 2005 and 2013. Patient characteristics, perioperative recovery, postoperative complications and pathology results were compared between the two groups. The patient characteri...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research
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