Transanal Total Mesorectal Excision (TaTME): Experience in Klaipėda University Hospital
Open Access
- 12 October 2019
- journal article
- Published by Vilnius University Press in Lietuvos chirurgija
- Vol. 18 (4), 235-238
- https://doi.org/10.15388/lietchirur.2019.18.15
Abstract
Introduction. Colorectal cancer ranks third on the list of the most common cancers. In 1979 R. J. Heald described total mesorectam excision (TME) which became a gold standard for rectal cancer treatment. This operation is performed all over the world open, laparoscopic and robotic. Operating on low and very low rectal cancer, distal bowel mobilisation if often the most difficult part of the operation. Aa a solution to this problem transanal abdominotransanal rectal resection (TATA) and transanal total mesorectal excision (TaTME) were proposed. This article reviews the experience and short-term postoperative outcomes of TaTME performed in Klaipėda University Hospital.Methods. The first stage of surgery was performed with patient placed in the prone jackknife (Kraske) position. Using electrocauthery circular mobilisation of the rectum was performed starting at least 1 cm from the lower edge of the tumour. Up to 10 cm of the rectum was mobilised from below. The second stage was performed with patient in lithotomy position. Laparoscopic TME was performed. For 11 (78.57%) patients hand sown anastomosis was performed and for 1 (7.17%) patient stapler was used. 2 (14.28%) patients underwent the Hartmann’s procedure.Results. In period 2018.03–2019.10 TaTME was performed for 14 patients. The medium tumour high counting from dentate line was 2.54 (±1.28). 13 out of 14 patients were operated from 8 to 12 weeks after chemoradiotherapy. All (100%) rectal resections were radical (R0). On average 11.43 (±3.78) lymphnodes were harvested. 5 (35.71%) patients had complications after surgery.Conclusions. TaTME performed at Klaipėda University Hospital is effective operation for rectal cancer treatment.Keywords
This publication has 8 references indexed in Scilit:
- Transanal versus abdominal low rectal dissection for rectal cancer: long-term results of the Bordeaux’ randomized trialSurgical Endoscopy, 2017
- Perineal Transanal ApproachAnnals of Surgery, 2014
- Laparoscopic transanal abdominal transanal resection with sphincter preservation for rectal cancer in the distal 3 cm of the rectum after neoadjuvant therapySurgical Endoscopy, 2010
- NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistanceSurgical Endoscopy, 2010
- Factors affecting the difficulty of laparoscopic total mesorectal excision with double stapling technique anastomosis for low rectal cancerSurgery, 2009
- Evidence of the Oncologic Superiority of Cylindrical Abdominoperineal Excision for Low Rectal CancerJournal of Clinical Oncology, 2008
- Classification of Surgical ComplicationsAnnals of Surgery, 2004
- Sphincter preservation for cancer of the distal rectum using high dose preoperative radiationInternational Journal of Radiation Oncology*Biology*Physics, 1988