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Surgical Endoscopy

Published in:

01-12-2014

Transanal versus traditional laparoscopic total mesorectal excision for rectal carcinoma

Authors: Simone Velthuis, Dorothee H. Nieuwenhuis, T. Emiel G. Ruijter, Miguel A. Cuesta, H. Jaap Bonjer, Colin Sietses

Published in: Surgical Endoscopy | Issue 12/2014

Abstract

Background

After total mesorectal excision (TME) surgery, patients with an incomplete mesorectum have an increased risk of local and overall recurrence. With the introduction of laparoscopic TME, an improved quality of the specimen was expected. However, the quality-related results were comparable to the results after traditional open surgery. Transanal TME is a new technique in which the rectum is mobilised by using a single-port and endoscopic instruments through the so called ‘down to up’ procedure. This new technique potentially leads to an improved specimen quality. This study was designed to investigate the pathological quality of specimens after transanal (TME) and to compare these with specimens after traditional laparoscopic TME.

Methods

This matched case control study compared the specimens of a cohort of consecutive patients who underwent transanal TME with the specimens after traditional laparoscopic TME. The pathological quality of the mesorectum was determined by the definitions of Quirke as ‘complete’, ‘nearly complete’, or ‘incomplete’.

Results

From June 2012 until July 2013, 25 consecutive patients underwent transanal TME because of a rectum carcinoma. Within the transanal TME group, 96 % of the specimens had a complete mesorectum, while in the traditional laparoscopic group, 72 % was deemed complete (p < 0.05). Other pathological characteristics, such as the circumferential resection margin, were comparable between the two groups.

Conclusions

Transanal TME appears associated with a significant higher rate of completeness of the mesorectum. Further studies are necessary to evaluate this novel technique.

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Title: Transanal versus traditional laparoscopic total mesorectal excision for rectal carcinoma
Authors: Simone Velthuis
Dorothee H. Nieuwenhuis
T. Emiel G. Ruijter
Miguel A. Cuesta
H. Jaap Bonjer
Colin Sietses
Publication date: 01-12-2014
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 12/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3636-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transanal versus traditional laparoscopic total mesorectal excision for rectal carcinoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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