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Laparoscopic Transanal Total Mesorectal Excision (taTME) for Rectal Cancer

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Abstract

Proper treatment of adenocarcinoma of the rectum demands a systematic, multidisciplinary approach where surgery remains the cornerstone of treatment. An evolving shift toward minimally invasive surgical approaches for rectal cancer continues to be hampered by the challenges of reliable pelvic exposure and adequate instrumentation for rectal dissection, distal rectal division, and low pelvic anastomosis. The laparoscopic transanal total mesorectal excision surgery has been developed as a novel alternative that provides solutions to many of the limitations of conventional open, laparoscopic and robotic proctectomy. This manuscript will describe the procedure in detail and attempt to define its role as the optimal surgical approach for rectal resection.

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References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015; 65:5.

    Article  PubMed  Google Scholar 

  2. Heald RJ, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986 Jun 28;1(8496):1479–82.

  3. Wibe A, Møller B, Norstein J, Carlsen E, Wiig JN, Heald RJ, Langmark F, Myrvold HE, Søreide O; Norwegian Rectal Cancer Group. A national strategic change in treatment policy for rectal cancer--implementation of total mesorectal excision as routine treatment in Norway. A national audit. Dis Colon Rectum. 2002 Jul;45(7):857–66.

  4. Martling AL, Holm T, Rutqvist LE, Moran BJ, Heald RJ, Cedemark B. Effect of a surgical training programme on outcome of rectal cancer in the County of Stockholm. Stockholm Colorectal Cancer Study Group, Basingstoke Bowel Cancer Research Project. Lancet. 2000 Jul 8;356(9224):93–6.

  5. Kapiteijn E, Putter H, van de Velde CJ; Cooperative investigators of the Dutch ColoRectal Cancer Group. Impact of the introduction and training of total mesorectal excision on recurrence and survival in rectal cancer in The Netherlands. Br J Surg. 2002 Sep;89(9):1142–9.

  6. Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004 May 13;350(20):2050–9.

  7. van der Pas MH, Haglind E, Cuesta MA, Fürst A, Lacy AM, Hop WC, Bonjer HJ; COlorectal cancer Laparoscopic or Open Resection II (COLOR II) Study Group. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013 Mar;14(3):210–8.

  8. Baik SH, Gincherman M, Mutch MG, Birnbaum EH, Fleshman JW. Laparoscopic vs open resection for patients with rectal cancer: comparison of perioperative outcomes and long-term survival. Dis Colon Rectum. 2011;54:6–14.

    Article  PubMed  Google Scholar 

  9. Kellokumpu IH, Kairaluoma MI, Nuorva KP, Kautiainen HJ, Jantunen IT. Short- and long-term outcome following laparoscopic versus open resection for carcinoma of the rectum in the multimodal setting. Dis Colon Rectum. 2012;55:854–863.

    Article  PubMed  Google Scholar 

  10. Park EJ, Cho MS, Baek SJ, Hur H, Min BS, Baik SH, Lee KY, Kim NK. Long-term oncologic outcomes of robotic low anterior resection for rectal cancer: a comparative study with laparoscopic surgery. Ann Surg. 2015 Jan;261(1):129–37.

  11. Kim CW, Kim CH, Baik SH. Outcomes of robotic-assisted colorectal surgery compared with laparoscopic and open surgery: a systematic review. J Gastrointest Surg. 2014 Apr;18(4):816–30.

  12. Masaaki Ito & Masanori Sugito & Akihiro Kobayashi & Yusuke Nishizawa & Yoshiyuki Tsunoda & Norio Saito. Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resection. Int J Colorectal Dis (2008) 23:703–707’

  13. Atallah S, Albert M, DeBeche-Adams T, Nassif G, Polavarapu H, Larach S. Transanal minimally invasive surgery for total mesorectal excision (TAMIS-TME): a stepwise description of the surgical technique with video demonstration. Tech Coloproctol. 2013 Jun;17(3):321–5.

  14. Atallah S, Martin-Perez B, Albert M, deBeche-Adams T, Nassif G, Hunter L, Larach S. Transanal minimally invasive surgery for total mesorectal excision (TAMIS-TME): results and experience with the first 20 patients undergoing curative-intent rectal cancer surgery at a single institution. Tech Coloproctol. 2014 May;18(5):473–80.

  15. Fernández-Hevia M, Delgado S, Castells A, Tasende M, Momblan D, Díaz Del Gobbo G, DeLacy B, Balust J, Lacy AM. Transanal Total Mesorectal Excision in Rectal Cancer: Short-term Outcomes in Comparison With Laparoscopic Surgery. Ann Surg. 2015 Feb;261(2):221–7.

  16. Sylla P, Bordeianou LG, Berger D, Han KS, Lauwers GY, Sahani DV, Sbeih MA, Lacy AM, Rattner DW. A pilot study of natural orifice transanal endoscopic total mesorectal excision with laparoscopic assistance for rectal cancer. Surg Endosc. 2013 Sep;27(9):3396–405.

  17. Rouanet P, Mourregot A, Azar CC, Carrere S, Gutowski M, Quenet F, Saint-Aubert B, Colombo PE. Transanal endoscopic proctectomy: an innovative procedure for difficult resection of rectal tumors in men with narrow pelvis. Dis Colon Rectum. 2013 Apr;56(4):408–15.

  18. de Lacy AM, Rattner DW, Adelsdorfer C, Tasende MM, Fernández M, Delgado S, Sylla P, Martínez-Palli G. 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. 2013;27:3165–3172.

    Article  PubMed  Google Scholar 

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Correspondence to Justin A. Maykel.

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Maykel, J.A. Laparoscopic Transanal Total Mesorectal Excision (taTME) for Rectal Cancer. J Gastrointest Surg 19, 1880–1888 (2015). https://doi.org/10.1007/s11605-015-2876-2

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  • DOI: https://doi.org/10.1007/s11605-015-2876-2

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