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Jamwal, Sonakshi, Rather, Jan Mohammad, Wani, Rouf A, Kumar, Arvind, Parray, Fazl Q, Chowdri, Nisar A. (1402). Transanal Total Mesorectal Excision for Rectal Cancer: Short and Midterm Results. سامانه مدیریت نشریات علمی, 11(3), 98-103. doi: 10.30476/acrr.2023.100370.1191
Sonakshi Jamwal; Jan Mohammad Rather; Rouf A Wani; Arvind Kumar; Fazl Q Parray; Nisar A Chowdri. "Transanal Total Mesorectal Excision for Rectal Cancer: Short and Midterm Results". سامانه مدیریت نشریات علمی, 11, 3, 1402, 98-103. doi: 10.30476/acrr.2023.100370.1191
Jamwal, Sonakshi, Rather, Jan Mohammad, Wani, Rouf A, Kumar, Arvind, Parray, Fazl Q, Chowdri, Nisar A. (1402). 'Transanal Total Mesorectal Excision for Rectal Cancer: Short and Midterm Results', سامانه مدیریت نشریات علمی, 11(3), pp. 98-103. doi: 10.30476/acrr.2023.100370.1191
Jamwal, Sonakshi, Rather, Jan Mohammad, Wani, Rouf A, Kumar, Arvind, Parray, Fazl Q, Chowdri, Nisar A. Transanal Total Mesorectal Excision for Rectal Cancer: Short and Midterm Results. سامانه مدیریت نشریات علمی, 1402; 11(3): 98-103. doi: 10.30476/acrr.2023.100370.1191

Transanal Total Mesorectal Excision for Rectal Cancer: Short and Midterm Results

Iranian Journal of Colorectal Research
مقاله 3، دوره 11، شماره 3، آذر 2023، صفحه 98-103    اصل مقاله (1.63 M)
نوع مقاله: Research/Original Article
شناسه دیجیتال (DOI): 10.30476/acrr.2023.100370.1191
نویسندگان
Sonakshi Jamwal1؛ Jan Mohammad Rather* 2؛ Rouf A Wani1؛ Arvind Kumar3؛ Fazl Q Parray1؛ Nisar A Chowdri1
1Department of General and Minimal Invasive Surgery, Skims Soura, JK
2Department of General and Minimal Invasive Surgery, Govt Medical College, Handwara, JK
3Department of General and Minimal Invasive Surgery, Sgrh, Delhi
چکیده
Background: Colorectal cancer is the third most common cancer affecting men and women in most Western countries and is the leading cause of cancer-related deaths. The primary goal of surgery is complete removal of rectal cancer. Total mesorectal excision (TME) is the cornerstone of curative therapy for rectal adenocarcinoma. Transanal total mesorectal excision (TaTME) was introduced for mid and lower rectal cancer and is proposed to allow a precise mesorectal dissection through better visualization in the anatomically limited pelvis. We aimed to check the feasibility of TaTME in terms of the quality of TME, circumferential resection margin positivity, lymph node yield, operation time, mean blood loss, postoperative complications, conversion rate, and hospital stay.
Methods: This was a cohort study from July 2018 to June 2020 to validate the efficacy of TaTME in our setup. It included biopsy-proven low and mid-rectal cancers (4-8 cm from the anal verge), T1 with node-positive disease or T2 and T3 with or without nodal disease. Statistical analysis was done by using SPSS software v24.
Results: Out of the total patients studied (n=35), 30 (85.7%) were men, and the rest were women. 14 patients received neoadjuvant therapy (40%). Overall, 30 (85.7%) had complete mesorectal excision, 4 (11.5%) patients had near complete mesorectal excision, and one had poor excision. 25 (71.4%) had moderately differentiated adenocarcinoma, 7 (20%) had poorly differentiated adenocarcinoma, and 3 (8.6%) had well-differentiated adenocarcinoma. 34 patients (97.2%) had normal distal resection margins, and only one (2.8%) had positive distal resection margins. Only 2 (5.8%) patients had positive circumferential resection margins (CRM). The mean tumor distance from the anal verge was 4.97 cm. The mean lymph node yield was 7.86±1.73. The mean operation time was 2.095 ±0.461 hours. The mean blood loss was 48.57±11.92 ml. Most patients (71.4%) had no postoperative complications at one month. However, urinary tract infection (8.6%), surgical site infection (5.7%), acute kidney injury (2.9%), anastomotic leak (2.9%), incontinence (2.9%), stromal retraction (2.9%), and rectovaginal fistula (2.9%) were noted. After three months, most patients had no complications (88.6%), though subacute intestinal obstruction occurred in 2 (5.7%) and sexual dysfunction occurred in 2 patients (5.7%). The mean hospital stay was 11.09±2.08 days.
Conclusion: The present study suggests TaTME might be a feasible method for oncologic resection of locally advanced mid- and distal-rectal cancer with curative intent. Intraoperative outcomes regarding conversion, surgical times, and intraoperative complications were very satisfactory. Short-term morbidity and oncologic outcomes were as good as in other laparoscopic TME series.
کلیدواژه‌ها
Colorectal cancer؛ Rectal cancer؛ Transanal Total Mesorectal Excision
مراجع
  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA: a cancer journal for clinicians. 2016;66(1):7-30.
  2. Nelson H, Sargent DJ, Wieand HS, Fleshman J, Anvari M, Stryker SJ, et al. A comparison of laparoscopically assisted and open colectomy for colon cancer. The New England journal of medicine. 2004;350(20):2050-9.
  3. Kang SB, Park JW, Jeong SY, Nam BH, Choi HS, Kim DW, et al. Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. The Lancet Oncology. 2010;11(7):637-45.
  4. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet (London, England). 2005;365(9472):1718-26.
  5. Stevenson ARL, Solomon MJ, Lumley JW, Hewett P, Clouston AD, Gebski VJ, et al. Effect of Laparoscopic-Assisted Resection vs Open Resection on Pathological Outcomes in Rectal Cancer: The ALaCaRT Randomized Clinical Trial. JAMA. 2015;314(13):1356-63.
  6. Atallah S. Transanal total mesorectal excision: full steam ahead. Techniques in coloproctology. 2015;19(2):57-61.
  7. Atallah S, Martin-Perez B, Albert M, deBeche-Adams T, Nassif G, Hunter L, et al. Transanal minimally invasive surgery for total mesorectal excision (TAMIS-TME): results and experience with the first 20 patients undergoing curative-intent rectal cancer surgery at a single institution. Techniques in coloproctology. 2014;18(5):473-80.
  8. Atallah S, Albert M, Monson JRT. Critical concepts and important anatomic landmarks encountered during transanal total mesorectal excision (taTME): toward the mastery of a new operation for rectal cancer surgery. Techniques in coloproctology. 2016;20(7):483-94.
  9. Marks JH, Montenegro GA, Salem JF, Shields MV, Marks GJ. Transanal TATA/TME: a case-matched study of taTME versus laparoscopic TME surgery for rectal cancer. Techniques in coloproctology. 2016;20(7):467-73.
  10. Denost Q, Adam J-P, Rullier A, Buscail E, Laurent C, Rullier E. Perineal transanal approach: a new standard for laparoscopic sphincter-saving resection in low rectal cancer, a randomized trial. Annals of Surgery. 2014;260(6):993-9.
  11. Lacy AM, Tasende MM, Delgado S, Fernandez-Hevia M, Jimenez M, De Lacy B, et al. Transanal Total Mesorectal Excision for Rectal Cancer: Outcomes after 140 Patients. Journal of the American College of Surgeons. 2015;221(2):415-23.
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