Transanal total mesorectal excision (TME) has been utilized as a minimally invasive surgery for colorectal cancer. Sylla et al. first reported the use of transanal TME and since then, various platforms have been applied for this procedure. The most widely used procedure is laparoscope-assisted transanal TME using a hybrid technique. de Lacy et al. introduced the Cecil procedure, which utilizes two teams (transabdominal and transanal). With regard to rectal cancer, a small group of authors attempted pure natural orifice transluminal endoscopic surgery (NOTES) transanal TME. The aim of this case report is to show that a transanal laparoscopic technique can be utilized for total colectomy. Except for rectal cancer, there are few reports regarding colon resection using NOTES. In this video, we perform a transanal total proctocolectomy with ileal pouch-anal anastomosis in a patient with synchronous triple colorectal cancer (ascending colon, rectosigmoid colon, and rectum). We performed transanal total proctocolectomy with ileal pouch-anal anastomosis in a patient with synchronous triple colorectal cancer (ascending colon, rectosigmoid colon, and rectum). On preoperative MRI, there was no pelvic lateral lymph node, so we did not need to perform chemoradiation therapy. After transanal dissection of the mesorectum, rectum was flipped into the intraperitoneal space for further dissection. In our setting, we used conventional laparoscopic instruments for most procedures and long-shafted instruments helped during mobilization of the splenic and hepatic flexures. The entire specimen was extracted transanally. The ileal pouch was constructed intracorporeally and ileal pouch-anal anastomosis was performed using a circular stapler. We did not create a defunctioning stoma. The operating time was 328 minutes and blood loss was <50 mL. We harvested 61 lymph nodes, and 1 regional lymph node metastasis was found. The patient experienced temporary paralytic ileus and was discharged on postoperative day 10 and had no major complications. The patient had medications for loose stool but had no incontinence. The patient refused adjuvant chemotherapy. During the 24 months follow-up period, there were no recurrences or metastases in three colonoscopies and three CT scans. This operation was performed in February 2017 and transanal total colectomy has not been reported so far. This transanal laparoscopic technique is feasible for total colectomy and may be adapted to achieve colonic resection through a natural orifice in the future. No competing financial interests exist. Runtime of video: 9 mins 55 secs This subject was previously presented at the International Society of University Colon and Rectal Surgeons (ISUCRS), August 29-September 1, 2018, in London, United Kingdom.
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http://dx.doi.org/10.1089/vor.2018.0566 | DOI Listing |
Eur J Surg Oncol
December 2024
Department of Computer Application, Guizhou University of Commerce, Guiyang, China. Electronic address:
Objective: This study aimed to compare the efficacy and safety of transanal total mesorectal excision (TaTME) with laparoscopic total mesorectal excision (LaTME) in patients with middle and low rectal cancer.
Methods: A comprehensive search of PubMed, Embase, and Cochrane databases was conducted to identify studies evaluating TaTME and LaTME from inception to June 2023. An additional search update was conducted in November 2024 to capture recently published studies.
Front Oncol
December 2024
Department of General Surgery, General Hospital of Northern Theater Command, Shenyang, China.
It is well established that host immunity plays a critical role in defending against colorectal cancer (CRC) progression. Connective tissue disease (CTD) encompasses a group of heterogeneous, immune-mediated disorders that present with diverse and often non-specific initial symptoms. Raynaud's phenomenon is a common feature, complicating early diagnosis.
View Article and Find Full Text PDFWorld J Gastroenterol
December 2024
Department of Surgery and Centre of Minimal Invasive Surgery, GFO Kliniken Bonn, Bonn 53225, North Rhine-Westphalia, Germany.
This manuscript focused on the surgical challenge of urinary and sexual dysfunction after rectal cancer surgery based on the interesting results demonstrated by the observational study of Chen , which was published in the . Urinary dysfunction occurs in one-third of patients treated for rectal cancer. Surgical nerve damage is the main cause of urinary dysfunction.
View Article and Find Full Text PDFTech Coloproctol
December 2024
Department of Digestive Surgical Oncology, Institut Paoli-Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille, France.
Background: Transanal total mesorectal excision (TaTME) is a promising and innovative approach for lower rectal cancer but requires high technical skill and learning process that can affect patient outcomes. We aimed to determine the learning curve of TaTME and then to assess its impact on 5-year oncologic outcomes.
Methods: Over a 54-month period, 94 patients underwent TaTME by experienced laparoscopic colorectal surgeons at our department.
Cir Esp (Engl Ed)
December 2024
Full professor at the University of Seville, Department of General and Digestive Surgery, Head of the Coloproctology Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Introduction: It is a priority to find surgical techniques that guarantee acceptable healing rates without sequelae in the treatment of complex anal fistula. The concept of the deep intersphincteric space as the origin of perianal sepsis has provided a new perspective, allowing the emergence of techniques such as TROPIS (Transanal Opening of Intersphincteric Space), with few published series to date. The aim of this study is to evaluate the healing rate and complications one year after the TROPIS technique as a treatment for complex anal fistula without hospitalization.
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