Transanal Assisted Resection with Closure of Anal Canal for Lower Rectal Diseases.

BACKGROUND/AIM: Abdominoperineal resection (APR) has been performed for lower rectal cancer, anal cancer and inflammatory diseases, but is associated with postoperative complications such as inflammation of pelvic dead space or perineal wound infection. We are performing a novel procedure (transanal assisted resection with closure of anal canal, TARC) that resects the intestine by using transanal assist and close the anal canal for patients who do not require resection of the anus and anal canal.

PATIENTS AND METHODS: From January 2015 to March 2017, nine patients (seven males, two females) underwent this procedure in our hospital for rectal cancer, recurrent rectal cancer, postoperative refractory pouchitis, and cervical cancer invaded to the rectum. The three patients diagnosed with rectal cancer underwent this procedure by a completely laparoscopic abdominal approach.

RESULTS: None developed postoperative dead space inflammation or perineal wound infections.

CONCLUSION: TARC seems to allow improved postoperative quality of life as compared to APR.