Skip to main content
Top
Published in: Techniques in Coloproctology 12/2017

01-12-2017 | Original Article

Initial experience with taTME in patients undergoing laparoscopic restorative proctocolectomy for familial adenomatous polyposis

Authors: P. C. Ambe, H. Zirngibl, G. Möslein

Published in: Techniques in Coloproctology | Issue 12/2017

Login to get access

Abstract

Background

Transanal total mesorectal excision (taTME) is a minimally invasive technique which was developed to overcome the difficulties associated with the “top-down” pelvic dissection by enabling a “bottom-up” dissection in patients with mid- and low rectal cancer. While this technique was primarily designed to manage tumors in the mid- and lower rectum, its spectrum of indications has been broadened to include benign colorectal pathologies. The aim of the present study was to assess our initial experience with taTME in patients undergoing restorative proctocolectomy for familial adenomatous polyposis (FAP).

Methods

All consecutive patients (undergoing prophylactic restorative proctocolectomy with IPAA for FAP using taTME between April and October 2016 at our institution) were included in the study.

Results

There were 8 patients (6 females and 2 males). The median age was 19.5 years (range 16–31 years). In all cases, surgery was successfully completed using with taTME. No perioperative complications were recorded. A median of 5 bowel movements (range 4–6 bowel movements) with intermittent anti-diarrheal medication was recorded in all cases.

Conclusions

Our initial experience with 8 consecutive cases suggests taTME is safe and effective in patients undergoing prophylactic restorative proctocolectomy with IPAA for FAP.
Literature
1.
go back to reference Deijen CL, Velthuis S, Tsai A et al (2016) COLOR III: a multicentre randomised clinical trial comparing transanal TME versus laparoscopic TME for mid and low rectal cancer. Surg Endosc 30:3210–3215CrossRefPubMed Deijen CL, Velthuis S, Tsai A et al (2016) COLOR III: a multicentre randomised clinical trial comparing transanal TME versus laparoscopic TME for mid and low rectal cancer. Surg Endosc 30:3210–3215CrossRefPubMed
2.
go back to reference Jayne DG, Thorpe HC, Copeland J, Quirke P, Brown JM, Guillou PJ (2010) Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 97:1638–1645CrossRefPubMed Jayne DG, Thorpe HC, Copeland J, Quirke P, Brown JM, Guillou PJ (2010) Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 97:1638–1645CrossRefPubMed
3.
go back to reference Atallah SB, Larach S, deBeche-Adams TC, Albert MR (2013) Transanal minimally invasive surgery (TAMIS): a technique that can be used for retrograde proctectomy. Dis Colon Rectum 56:931CrossRefPubMed Atallah SB, Larach S, deBeche-Adams TC, Albert MR (2013) Transanal minimally invasive surgery (TAMIS): a technique that can be used for retrograde proctectomy. Dis Colon Rectum 56:931CrossRefPubMed
4.
go back to reference de Lacy AM, Rattner DW, Adelsdorfer C et al (2013) Transanal natural orifice transluminal endoscopic surgery (NOTES) rectal resection: “down-to-up” total mesorectal excision (TME)—short-term outcomes in the first 20 cases. Surg Endosc 27:3165–3172CrossRefPubMed de Lacy AM, Rattner DW, Adelsdorfer C et al (2013) Transanal natural orifice transluminal endoscopic surgery (NOTES) rectal resection: “down-to-up” total mesorectal excision (TME)—short-term outcomes in the first 20 cases. Surg Endosc 27:3165–3172CrossRefPubMed
5.
go back to reference Marks JH, Montenegro GA, Salem JF, Shields MV, Marks GJ (2016) Transanal TATA/TME: a case-matched study of taTME versus laparoscopic TME surgery for rectal cancer. Tech Coloproctol 20:467–473CrossRefPubMed Marks JH, Montenegro GA, Salem JF, Shields MV, Marks GJ (2016) Transanal TATA/TME: a case-matched study of taTME versus laparoscopic TME surgery for rectal cancer. Tech Coloproctol 20:467–473CrossRefPubMed
6.
go back to reference Rouanet P, Mourregot A, Azar CC et al (2013) Transanal endoscopic proctectomy: an innovative procedure for difficult resection of rectal tumors in men with narrow pelvis. Dis Colon Rectum 56:408–415CrossRefPubMed Rouanet P, Mourregot A, Azar CC et al (2013) Transanal endoscopic proctectomy: an innovative procedure for difficult resection of rectal tumors in men with narrow pelvis. Dis Colon Rectum 56:408–415CrossRefPubMed
7.
go back to reference Araujo SE, Crawshaw B, Mendes CR, Delaney CP (2015) Transanal total mesorectal excision: a systematic review of the experimental and clinical evidence. Tech Coloproctol 19:69–82CrossRefPubMed Araujo SE, Crawshaw B, Mendes CR, Delaney CP (2015) Transanal total mesorectal excision: a systematic review of the experimental and clinical evidence. Tech Coloproctol 19:69–82CrossRefPubMed
8.
go back to reference Arroyave MC, DeLacy FB, Lacy AM (2017) Transanal total mesorectal excision (TaTME) for rectal cancer: step by step description of the surgical technique for a two-teams approach. Eur J Surg Oncol 43:502–505CrossRefPubMed Arroyave MC, DeLacy FB, Lacy AM (2017) Transanal total mesorectal excision (TaTME) for rectal cancer: step by step description of the surgical technique for a two-teams approach. Eur J Surg Oncol 43:502–505CrossRefPubMed
9.
go back to reference Atallah S, Martin-Perez B, Larach S (2015) Image-guided real-time navigation for transanal total mesorectal excision: a pilot study. Tech Coloproctol 19:679–684CrossRefPubMed Atallah S, Martin-Perez B, Larach S (2015) Image-guided real-time navigation for transanal total mesorectal excision: a pilot study. Tech Coloproctol 19:679–684CrossRefPubMed
10.
go back to reference Hanke L, Bartsch F, Försch S, Lang H, Kneist W (2016) TaTME zur Restproktomukosektomie mit ileoanaler Pouchanlage bei Colitis ulcerosa-assoziiertem Karzinom und Adipositas. Z Gastroenterol 54:KV100CrossRef Hanke L, Bartsch F, Försch S, Lang H, Kneist W (2016) TaTME zur Restproktomukosektomie mit ileoanaler Pouchanlage bei Colitis ulcerosa-assoziiertem Karzinom und Adipositas. Z Gastroenterol 54:KV100CrossRef
12.
go back to reference Möslein G (2016) Surgical considerations in FAP-related pouch surgery: could we do better? Fam Cancer 15:457–466CrossRefPubMed Möslein G (2016) Surgical considerations in FAP-related pouch surgery: could we do better? Fam Cancer 15:457–466CrossRefPubMed
13.
go back to reference Lovegrove RE, Constantinides VA, Heriot AG et al (2006) A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. Ann Surg 244:18–26CrossRefPubMedPubMedCentral Lovegrove RE, Constantinides VA, Heriot AG et al (2006) A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. Ann Surg 244:18–26CrossRefPubMedPubMedCentral
14.
go back to reference Mari FS, Di Cesare T, Novi L et al (2015) Does ghost ileostomy have a role in the laparoscopic rectal surgery era? A randomized controlled trial. Surg Endosc 29:2590–2597CrossRefPubMed Mari FS, Di Cesare T, Novi L et al (2015) Does ghost ileostomy have a role in the laparoscopic rectal surgery era? A randomized controlled trial. Surg Endosc 29:2590–2597CrossRefPubMed
15.
go back to reference Coffey JC, Dillon MF, O’Driscoll JS, Faul E (2016) Transanal total mesocolic excision (taTME) as part of ileoanal pouch formation in ulcerative colitis—first report of a case. Int J Colorectal Dis 31:735–736CrossRefPubMed Coffey JC, Dillon MF, O’Driscoll JS, Faul E (2016) Transanal total mesocolic excision (taTME) as part of ileoanal pouch formation in ulcerative colitis—first report of a case. Int J Colorectal Dis 31:735–736CrossRefPubMed
16.
go back to reference Leo CA, Samaranayake S, Perry-Woodford ZL et al (2016) Initial experience of restorative proctocolectomy for ulcerative colitis by transanal total mesorectal rectal excision and single-incision abdominal laparoscopic surgery. Colorectal Dis 18:1162–1166CrossRefPubMed Leo CA, Samaranayake S, Perry-Woodford ZL et al (2016) Initial experience of restorative proctocolectomy for ulcerative colitis by transanal total mesorectal rectal excision and single-incision abdominal laparoscopic surgery. Colorectal Dis 18:1162–1166CrossRefPubMed
17.
go back to reference Atallah S, Albert M, Monson JR (2016) Critical concepts and important anatomic landmarks encountered during transanal total mesorectal excision (taTME): toward the mastery of a new operation for rectal cancer surgery. Tech Coloproctol 20:483–494CrossRefPubMed Atallah S, Albert M, Monson JR (2016) Critical concepts and important anatomic landmarks encountered during transanal total mesorectal excision (taTME): toward the mastery of a new operation for rectal cancer surgery. Tech Coloproctol 20:483–494CrossRefPubMed
18.
go back to reference Chen CC, Lai YL, Jiang JK et al (2016) Transanal total mesorectal excision versus laparoscopic surgery for rectal cancer receiving neoadjuvant chemoradiation: a matched case-control study. Ann Surg Oncol 23:1169–1176CrossRefPubMed Chen CC, Lai YL, Jiang JK et al (2016) Transanal total mesorectal excision versus laparoscopic surgery for rectal cancer receiving neoadjuvant chemoradiation: a matched case-control study. Ann Surg Oncol 23:1169–1176CrossRefPubMed
19.
go back to reference Kneist W, Hanke L, Kauff DW, Lang H (2016) Surgeons’ assessment of internal anal sphincter nerve supply during TaTME—inbetween expectations and reality. Minim Invasive Ther 25:241–246CrossRef Kneist W, Hanke L, Kauff DW, Lang H (2016) Surgeons’ assessment of internal anal sphincter nerve supply during TaTME—inbetween expectations and reality. Minim Invasive Ther 25:241–246CrossRef
20.
go back to reference Dörner J, Ambe PC, Möslein G (2017) Chirurgische Prävention hereditärer gastrointestinaler Tumordispositionen. Der Onkologe 23:446–452CrossRef Dörner J, Ambe PC, Möslein G (2017) Chirurgische Prävention hereditärer gastrointestinaler Tumordispositionen. Der Onkologe 23:446–452CrossRef
21.
go back to reference Walter T, Zhenzhen Wang C, Guillaud O et al (2016) Management of desmoid tumours: a large national database of familial adenomatous patients shows a link to colectomy modalities and low efficacy of medical treatments. United Eur Gastroenterol. https://doi.org/10.1177/2050640616678150 Walter T, Zhenzhen Wang C, Guillaud O et al (2016) Management of desmoid tumours: a large national database of familial adenomatous patients shows a link to colectomy modalities and low efficacy of medical treatments. United Eur Gastroenterol. https://​doi.​org/​10.​1177/​2050640616678150​
Metadata
Title
Initial experience with taTME in patients undergoing laparoscopic restorative proctocolectomy for familial adenomatous polyposis
Authors
P. C. Ambe
H. Zirngibl
G. Möslein
Publication date
01-12-2017
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 12/2017
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-017-1730-9

Other articles of this Issue 12/2017

Techniques in Coloproctology 12/2017 Go to the issue