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Feasibility study of transanal total mesorectal excision
S Velthuis1, P B van den Boezem, D L van der Peet
1Department of Surgery, Gelderse Vallei Hospital, Ede, The Netherlands.
The British Journal of Surgery
|February 27, 2013
Summary
Transanal total mesorectal excision (TME) is a feasible new surgical approach for rectal cancer. This technique allows for complete rectal dissection, but long-term oncological outcomes require further study.
Area of Science:
- Colorectal surgery
- Surgical oncology
- Minimally invasive surgery
Background:
- Laparoscopic resection of colorectal cancers is a safe alternative to open surgery.
- Conversion to open surgery increases morbidity.
- Transanal total mesorectal excision (TME) is an emerging technique for rectal cancer excision.
Purpose of the Study:
- To describe the initial feasibility and results of transanal TME.
- To evaluate the safety and efficacy of this novel surgical approach.
Main Methods:
- Five consecutive patients with rectal carcinoma underwent transanal TME.
- The rectum was mobilized peranally using endoscopic instruments.
- Surgical excision of rectal tumors was performed via a transanal approach.
Main Results:
- Complete transanal endoscopic dissection of the rectum was achieved in all patients.
- Histopathology confirmed clear surgical margins and intact mesorectal fascia.
- One patient developed a presacral abscess; median operation time was 175 minutes.
Conclusions:
- Transanal TME, utilizing a down-to-up dissection principle, is a feasible surgical technique.
- Further research is needed to compare its oncological and clinical outcomes with standard laparoscopic or open TME.
