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transanal mesorectal excision

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https://www.readbyqxmd.com/read/28444558/evolution-of-surgical-treatment-for-rectal-cancer-a-review
#1
Sanjeev Dayal, Nick Battersby, Tom Cecil
Surgery that produces an optimal total mesorectal excision (TME) resection specimen remains the cornerstone of curative rectal cancer management. In the modern era, despite the results of recent randomised trials, laparoscopic TME is a crucial technique in the TME surgery armamentarium. Laparoscopic surgery offers the benefit of magnified views that aid sharp and precise dissection. However operating in the confines of a narrow pelvis, particularly when the mesorectum is bulky, requires significant technical skill...
April 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28436197/magnetic-resonance-imaging-following-neoadjuvant-chemoradiation-and-transanal-endoscopic-microsurgery-for-rectal-cancer
#2
Guilherme P São Julião, Cinthia Denise Ortega, Bruna Borba Vailati, Angelita Habr-Gama, Laura Melina Fernandez, Joaquim Gama-Rodrigues, Sergio Eduardo Araujo, Rodrigo O Perez
AIM: Full thickness local excision after neoadjuvant chemoradiotherapy (CRT) for patients with rectal cancer and incomplete clinical response has been a treatment strategy for organ preservation. Follow up of these patients is challenging since anatomic distortion and postoperative changes may be clinically indistinguishable from tumor recurrence. Magnetic resonance imaging (MRI) may have a role in detecting recurrence. The aim of this study is to describe the MRI findings during follow-up in patients having local excision following CRT with and without local recurrence...
April 24, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28399840/a-multicentre-randomised-controlled-trial-to-evaluate-the-efficacy-morbidity-and-functional-outcome-of-endoscopic-transanal-proctectomy-versus-laparoscopic-proctectomy-for-low-lying-rectal-cancer-etap-greccar-11-trial-rationale-and-design
#3
Bernard Lelong, Cécile de Chaisemartin, Helene Meillat, Sandra Cournier, Jean Marie Boher, Dominique Genre, Mehdi Karoui, Jean Jacques Tuech, Jean Robert Delpero
BACKGROUND: Total mesorectal excision is the standard surgical treatment for mid- and low-rectal cancer. Laparoscopy represents a clear leap forward in the management of rectal cancer patients, offering significant improvements in post-operative measures such as pain, first bowel movement, and hospital length of stay. However, there are still some limits to its applications, especially in difficult cases. Such cases may entail either conversion to an open procedure or positive resection margins...
April 11, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28381943/transanal-total-mesorectal-excision-a-novel-approach-to-rectal-surgery
#4
REVIEW
Pasithorn A Suwanabol, Justin A Maykel
Less invasive approaches continue to be explored and refined for diseases of the colon and rectum. The current gold standard for the surgical treatment of rectal cancer, total mesorectal excision (TME), is a technically precise yet demanding procedure with outcomes measured by both oncologic and functional outcomes (including bowel, urinary, and sexual). To date, the minimally invasive approach to rectal cancer has not yet been perfected, leaving ample opportunity for rectal surgeons to innovate. Transanal TME has recently emerged as a safe and effective technique for both benign and malignant diseases of the rectum...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28346223/early-rectal-cancer-a-choice-between-local-excision-and-transabdominal-resection-a-review-of-the-literature-and-current-guidelines
#5
Giuseppe Pappalardo, Massimo Chiaretti
INTRODUCTION: Indication for Local Excision (LE) or Trans Abdominal Resections with Total Mesorectal Excision (TAR) in Early Rectal Cancer (ERC) are still controversial. MATERIAL OF STUDY: We reviewed meta-analyses, scientific societies guidelines, randomized and controlled clinical trials from 1999 to 2016 for a total of 146,231 patients. We included in our analysis the accuracy of different tools of investigation, the reliability of the endoscopic biopsies and compared the results of the various LE and TAR...
March 27, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28281474/combined-laparoscopic-and-transanal-total-mesorectal-excision-for-rectal-cancer-initial-experience-and-early-results
#6
Morten Holt Thomsen, Henrik Ovesen, Jens Ravn Eriksen
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...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28265766/combined-transanal-total-mesorectal-excision-tatme-with-laparoscopic-instruments-and-abdominal-robotic-surgery-in-rectal-cancer
#7
R Bravo, J-S Trépanier, M C Arroyave, M Fernández-Hevia, A Pigazzi, A M Lacy
Laparoscopic surgery for rectal cancer can be technically challenging. We describe a hybrid technique combining abdominal robotic dissection and transanal total mesorectal excision. This procedure was performed in a 50-year-old man with rectal adenocarcinoma at 5 cm from the dentate lane. Preoperative staging was T2N0M0. Surgery went well without complications, and estimated blood loss was less than 50 mL. Robotic surgical time was 90 min, and total operative time was 160 min. The patient was discharged on postoperative day 3...
March 6, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28099070/laparoscopic-rectal-dissection-assisted-by-transanal-endoluminal-videoendoscopy-through-a-blunt-tip-trocar
#8
Emanuele Asti, Andrea Lovece, Luigi Bonavina
BACKGROUND AND AIMS: Laparoscopic resection is a well-established approach for colorectal cancer surgery. In patients with rectal cancer treated by neoadjuvant chemoradiotherapy, it may be difficult to identify a clear safety margin for endostapling and subsequent anastomosis. We designed an innovative technical approach to assist colorectal anastomosis in these patients. TECHNIQUE: A four-trocar laparoscopic approach is used. After exploration of the abdominal cavity, the left colic flexure is completely mobilized...
January 18, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28092017/transanal-total-mesorectal-excision-for-a-large-leiomyosarcoma-at-the-lower-rectum-a-case-report-and-literature-review
#9
Nobuaki Hoshino, Koya Hida, Kenji Kawada, Takaki Sakurai, Yoshiharu Sakai
BACKGROUND: Rectal leiomyosarcoma (LMS) is an extremely rare disease. Previously, LMS was not properly distinguishable from gastrointestinal stromal tumor (GIST) until c-kit, a characteristic marker of GIST, was discovered in 1998. No standard therapeutic strategy for gastrointestinal LMS has been established except for surgical resection because of its rarity. Rectal LMS is often accompanied by symptoms, which can enable detection at a small size. However, when a large LMS is detected at the lower rectum, it is difficult to excise due to the narrow pelvic space...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28044239/transanal-total-mesorectal-excision-tatme-for-rectal-cancer-effects-on-patient-reported-quality-of-life-and-functional-outcome
#10
T W A Koedam, G H van Ramshorst, C L Deijen, A K E Elfrink, W J H J Meijerink, H J Bonjer, C Sietses, J B Tuynman
BACKGROUND: Transanal total mesorectal excision (TaTME) has rapidly become an important component of the treatment of rectal cancer surgery. Cohort studies have shown feasibility concerning procedure, specimen quality and morbidity. However, concerns exist about quality of life and ano(neo)rectal function. The aim of this study was to prospectively evaluate quality of life in patients following TaTME for rectal cancer with anastomosis. METHODS: Consecutive patients who underwent restorative TaTME surgery for rectal adenocarcinoma in an academic teaching center with tertiary referral function were evaluated...
January 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28024946/short-and-mid-term-outcomes-after-endoscopic-transanal-or-laparoscopic-transabdominal-total-mesorectal-excision-for-low-rectal-cancer-a-single-institutional-case-control-study
#11
Bernard Lelong, Hélène Meillat, Christophe Zemmour, Flora Poizat, Jacques Ewald, Diane Mege, Jean-Claude Lelong, Jean Robert Delpero, Cécile de Chaisemartin
BACKGROUND: Transabdominal laparoscopic proctectomy (LAP) for rectal cancer was associated with postoperative recovery improvement. Early studies showed favorable short-term results of endoscopic transanal proctectomy (ETAP), with low conversion rates to open procedures. We aimed to compare efficacy, morbidity, and functional outcomes of ETAP to standard LAP for low rectal cancer. STUDY DESIGN: From 2008 to 2013, 72 consecutive patients received proctectomy and coloanal manual anastomosis for low rectal adenocarcinoma...
December 24, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28000657/combined-laparoscopic-and-transanal-total-mesorectal-excision-for-rectal-cancer-initial-experience-and-early-results
#12
Morten Holt Thomsen, Henrik Ovesen, Jens Ravn Eriksen
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...
December 21, 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27997526/organ-preservation-with-local-excision-or-active-surveillance-following-chemoradiotherapy-for-rectal-cancer
#13
B Creavin, E Ryan, S T Martin, A Hanly, P R O'Connell, K Sheahan, D C Winter
BACKGROUND: Organ preservation has been proposed as an alternative to radical surgery for rectal cancer to reduce morbidity and mortality, and to improve functional outcome. METHODS: Locally advanced non-metastatic rectal cancers were identified from a prospective database. Patients staged ⩾T3 or any stage N+ were referred for neoadjuvant chemoradiotherapy (CRT) (50-54 Gy and 5-fluorouracil), and were reassessed 6-8 weeks post treatment. An active surveillance programme ('watch and wait') was offered to patients who were found to have a complete endoluminal response...
January 17, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/27990592/combined-notes-total-mesorectal-excision-and-single-incision-laparoscopy-principles-for-conservative-proctectomy-a-single-centre-study
#14
H Meillat, C de Chaisemartin, F Poizat, E Bories, R Fara, J R Delpero, B Lelong
BACKGROUND: Surgery for low rectal cancer remains a challenge when a standard laparoscopic approach is used. Transanal endoscopic total mesorectal excision (TME) has been shown to be feasible and to be associated with a low conversion rate. Combining the transanal and transabdominal single-port approaches (with an abdominal single port implanted in the future stoma and extraction site) could allow TME with minimal wound trauma, low morbidity, and faster recovery. The aim of the current study was to assess the short- and mid-term results of this technique...
January 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27934790/abdomino-endoscopic-perineal-excision-of-the-rectum-for-benign-and-malignant-pathology-technique-considerations-for-true-transperineal-verus-transanal-total-mesorectal-excision-endoscopic-proctectomy
#15
Hazar Al Furajii, Niall Kennedy, Ronan A Cahill
PURPOSE: Transanal minimally invasive surgery using single port instrumentation is now well described for the performance of total mesorectal excision with restorative colorectal/anal anastomosis most-often in conjunction with transabdominal multiport assistance. While non-restorative abdomino-endoscopic perineal excision of the anorectum is conceptually similar, it has been less detailed in the literature. METHODS: Consecutive patients undergoing non-restorative ano-proctectomy including a transperineal endoscopic component were analysed...
January 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27914773/transanal-total-mesorectal-excision-tatme-for-rectal-cancer-step-by-step-description-of-the-surgical-technique-for-a-two-teams-approach
#16
M C Arroyave, F B DeLacy, A M Lacy
Interest in transanal total mesorectal excision (TaTME) is growing worldwide due to the application of minimally invasive techniques to rectal cancer surgery while maintaining adequate oncologic outcomes. This article presents the standardised and refined technique after performing more than 300 operations at Hospital Clinic of Barcelona.
February 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27885870/transanal-total-mesorectal-excision-for-restorative-coloproctectomy-in-an-obese-high-risk-patient-with-colitis-associated-carcinoma
#17
Laura Isabel Hanke, Fabian Bartsch, Sebastian Försch, Florian Heid, Hauke Lang, Werner Kneist
Transanal total mesorectal excision (TaTME) offers great potential for the treatment of malign and benign diseases. However, laparoscopic-assisted TaTME in ulcerative colitis has not been described in more than a handful of patients. We present a 47-year-old highly comorbid female patient with an ulcerative colitis-associated carcinoma of the ascending colon and steroid-refractory pancolitis. A two-stage restorative coloproctectomy including right-sided complete mesocolic excision was conducted. The second step consisted of a successful nerve-sparing TaTME and a handsewn ileal pouch-anal anastomosis...
November 25, 2016: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/27853973/clinical-outcomes-and-case-volume-effect-of-transanal-total-mesorectal-excision-for-rectal-cancer-a-systematic-review
#18
REVIEW
C L Deijen, A Tsai, T W A Koedam, M Veltcamp Helbach, C Sietses, A M Lacy, H J Bonjer, J B Tuynman
Transanal total mesorectal excision (TaTME) has been developed to improve quality of TME for patients with mid and low rectal cancer. However, despite enthusiastic uptake and teaching facilities, concern exists for safe introduction. TaTME is a complex procedure and potentially a learning curve will hamper clinical outcome. With this systematic review, we aim to provide data regarding morbidity and safety of TaTME. A systematic literature search was performed in MEDLINE (PubMed), EMBASE (Ovid) and Cochrane Library...
December 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27777876/transanal-total-mesorectal-excision-myths-and-reality
#19
EDITORIAL
Nicolas C Buchs, Marta Penna, Alexander L Bloemendaal, Roel Hompes
Transanal total mesorectal excision (TaTME) is a new and promising approach for the treatment of rectal cancer. Whilst the experience is still limited, there are growing evidences that this approach might overcome the limits of standard low anterior resection. TaTME might help to decrease the conversion rate especially in difficult patients, and to improve the pathological results, while preserving the urogenital function. Evaluation of data from large registries and randomized studies should help to draw firmer conclusions...
October 10, 2016: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27757396/feasibility-of-transanal-endoscopic-total-mesorectal-excision-for-rectal-cancer-results-of-a-pilot-study
#20
Jae Hwan Oh, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jong Hee Hyun, Hee Jin Chang, Kyung Su Han, Dae Kyung Sohn
PURPOSE: To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. METHODS: This study enrolled 12 patients with clinically node negative rectal cancer located 4-12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of single port laparoscopic surgery between September 2013 and August 2014. The primary endpoint was TME quality; secondary endpoints included number of harvested lymph nodes and postoperative complications within 30 days (NCT01938027)...
October 2016: Annals of Surgical Treatment and Research
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