scholarly journals Comparison of the perioperative outcomes of laparoscopic surgery, robotic surgery, open surgery, and transanal total mesorectal excision for rectal cancer: An overview of systematic reviews

2020 ◽  
Vol 4 (6) ◽  
pp. 628-634
Author(s):  
Seiichiro Yamamoto
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Robotic Surgery ◽  
Total Mesorectal Excision ◽  
Systematic Reviews ◽  
Open Surgery ◽  
Perioperative Outcomes ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Overview Of Systematic Reviews

scholarly journals Rate of local recurrence in a cohort of 125 patients treated by transanal total mesorectal excision due to rectal cancer

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
P Gioia ◽  
S Gloor ◽  
R Troller ◽  
M Adamina
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Total Mesorectal Excision ◽  
Operating Time ◽  
Disease Free Survival ◽  
Low Rectal Cancer ◽  
Perioperative Outcomes ◽  
Transanal Total Mesorectal Excision ◽  
Distal Margin ◽  
Mesorectal Excision

Abstract Objective Transanal total mesorectal excision (taTME) is an alternative to conventional TME owing to its reported superior ability to achieve clear resection margins in low rectal cancers. Yet, nationwide Norwegian data claimed a 12-month local recurrence rate of up to 10%, a three-fold increase compared to conventional TME, questioning the oncological safety of taTME. Methods Consecutive patients with low rectal cancer treated by taTME were prospectively included. Patients who required a partial mesorectal excision were excluded. Perioperative outcomes were reported as median and interquartile range (IQR). Data were independently audited and certified. Results 125 patients (88 men : 37 women) with a low rectal cancer (7 cm to anal verge, IQR 5-9) underwent a taTME. Age and body mass index were 65 years (IQR 56-76) and 26 kg/m2 (IQR 23-29). 87 (70%) patients had neoadjuvant radiochemotherapy. Surgery time was 357 minutes (IQR 303-435), including an ileostomy in all patients. 1 patient (0.8%) required a conversion to laparotomy. Performing taTME in a 2-team technique saved 94 minutes or 19% operating time (p < 0.005, t-test one-team (n = 52, 420 minutes, IQR 349-494) vs. 2-team (n = 73, 326 minutes, IQR 285-372). 30-day morbidity amounted to 36% minor complications (Dindo Clavien I-II) and 25% major complications (Dindo Clavien III-V), including 11 anastomotic leaks (9%) and 3 reoperations (3%). Most of the leaks could be managed endoscopically and the ileostomy reversed at last. Median length of hospital stay was 10 days (IQR 8-14). Median follow-up was 45 months (IQR 25-67; range 13-95). Dissection of the mesorectum was excellent (Quirke 1 incomplete mesorectal excision rate: 1.6%) with 100% clear margins (distal margin 16mm, IQR 10-30; circumferential margin 10mm, IQR 5-15). Median T stage was 3 (IQR 2-3). 24 patients had positive lymphnodes (median 27, IQR 21-38). Local recurrence occurred in 7 (6%) patients and development of metachronous metastasis was present in 36 (29%) patients. This led to a 5-year disease-free survival of 56% and a 5-year overall survival of 86%. Conclusion Transanal total mesorectal excision allows good surgical and oncologic quality to the expenses of a reasonable surgery time and morbidity.

scholarly journals Transanal total mesorectal excision and transabdominal robotic surgery for rectal cancer: A retrospective study

2021 ◽  
Vol 70 ◽  
pp. 102902
Author(s):  
Hiroshi Oshio ◽  
Yukiko Oshima ◽  
Gen Yunome ◽  
Shinji Okazaki ◽  
Ichiro Kawamura ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Retrospective Study ◽  
Robotic Surgery ◽  
Total Mesorectal Excision ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision
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