Adrian Maghiar, George Dejeu, Octavian Maghiar. Spital Pelican Oradea
In our institution we have a vast experience with rectal cancer patients, with a number of over 50 cases per year that get resection with anastomosis. In the recent years we have started studying and attending courses to using TA-TME. We have a 8 years experience of using transanal devices for both benign and malignant disease, but we only started doing TA-TME in our Clinic this year.
We present our experience after 5 cases of low rectal cancer patients using the transanal approach for the rectal dissection, using the conventional laparoscopic approach for the vascular dissection and the left colon mobilisation (we always mobilise the splenic flexure).
We operated on 4 men and 1 female. All patient were between the ages of 60 and 75, with no major comorbidities (3 male and 1 female with hypertension and 2 male with diabetes). The mean operating time was 230 minutes, with the first case lasting 320 minutes and last one 195 minutes (skin to skin). All cases were R0 resection, with an average lymph node harvest of 16 nodes (13 to 25), and an average height of the anastomosis of 3 cm (1,5 to 4 cm). The average length of stay was 7 days (5 to 14). All patients had a ileostomy done prior to neoadjuvant therapy. 2 patients needed readmission before 30 days after surgery (one for constipation and dehydration, and one for vomiting). None patients presented with fistula, and all patients had their ileostomy reversed after 6 weeks with normal bowel function at 3 and 6 months (3 cases have more than 6 months, one has less than 3 months after surgery). We conclude that TA-TME is feasible in a center with a reasonably high volume of rectal cancer patients and a big experience with advanced oncologic laparoscopic surgery. The duration of surgery goes down with experience, but the visualisation during dissection is much superior than that of the normal laparoscopic approach. Needs further study to see the benefits compared to the robotic approach (we have no experience with the robot).
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95947
Program Number: P283
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster