Jacek Piatkowski, Md, PhD, Marek Jackowski, Prof. Clinic of General, Gastroenterological and Oncological Surgery
Introduction: More than 10 years ago, laparoscopic technique was considered to be a fully accepted surgical method for treatment of rectal cancer. The following years are a further search for a new surgical method that reduces invasiveness and improves treatment outcomes.
It seems that such a method is transanal total mesorectal excision.
The aim of this study was to evaluate the new method of rectal cancer surgery (TaTME) after 2 years of its use.
Methods: Radicality of treatment (R0 resection, local recurrence), outcome of surgical treatment and quality of life of patients after surgery were evaluated.
Results: In the period from 10.03.2015. – 30.06.2017. 33 patients (19 men, 14 women) were operated in the Clinic. In 29 cases the indication for surgery was lower and middle rectal cancer and in 4 cases high grade dysplasia. All patients underwent laparoscopic rectal proctectomy with transanal access (TaTME). In all cases, complete oncological radicalization (resection R0) was obtained. The average operation time was 156 minutes. We had used two teams approach ( Cecil approach) with 2 laparoscopic sets – abdominal and perineal starting at the same time.
In the postoperative course, 6 patients had signs of anastomosis leak (3 of them required reoperation).
The follow-up period is 1-29 months. None of the patients had any recurrence of cancer.
Conclusions:
1. Transanal TME for rectal cancer surgery is an alternative method to conventional laparoscopic surgery.
2. In a large proportion of patients with lower and middle tumors, the rectum can avoid abdomino-perineal resection with permanent colostomy.
3. Because of the small group of patients and short observation period, the method requires further investigation
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86809
Program Number: P236
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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