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Transanal Total Mesorectal Excision for Treatment of Carcinoma in the Middle or Lower Third Rectum: the Technical Feasibility of the Procedure, Pathological Results, and Clinical Outcome

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Abstract

We are trying to illustrate operative, short-term, and pathological outcomes of transanal total mesorectal excision (TaTME) as a surgical procedure for patients who are suffering cancer in the lower or middle rectum. This study included 25 consecutive patients who underwent TaTME for the mid and low cancer rectum. The primary outcome measures included frequency of postoperative (PO) bleeding, leakage, ileus, days to regain bowel function, days for Foley’s removal, and erectile function. The secondary outcome measures included operation time, status of resection margins, number, the quality of TME, and duration PO hospital stay. No recorded intraoperative complications. The mean hospital stay was 6.9 ± 2.6 days. The mean duration need for urinary catheter removal and flatus passage were 2.4 ± 2.1 and 1.5 + 0.9 days, respectively. The mean IPSS was returned to normal 12 months after surgery. The mean distal margin distance was 1.9 ± 1.1. Circumferential margin distance was > 1 mm in 23 (92%) patients. The mesorectum was complete in 22 (88%) patients. The survival rate was 88% over 3 years. TaTME could be considered as a safe, feasible, and effective surgical modality for patients who had mid and lower rectal tumors with an excellent pathological outcome.

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Authors and Affiliations

Authors

Contributions

Concept and design: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD

Manuscript preparation: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD

Data and statistical analysis: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD

Manuscript editing: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD

Literature search: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD

Manuscript review: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD

Corresponding author

Correspondence to Ashraf M. Abdelkader.

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Conflicts of Interest

The authors declare that they have no conflicts of interest.

Patient Consent

Patient informed consents were obtained before the operation, as with all procedures.

Ethics Approval

This data collection was approved by the Ethical Committee of our hospital.

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Synopsis

In this study, we are trying to illustrate the operative, clinical, and pathological outcomes of TaTME as a surgical procedure for patients who are suffering cancer in the lower or middle rectum. We included 25 patients in our study over 3 years. Operations done laparoscopically, specimens examined histologically then patient followed postoperatively.

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Abdelkader, A.M., Zidan, A.M., Younis, M.T. et al. Transanal Total Mesorectal Excision for Treatment of Carcinoma in the Middle or Lower Third Rectum: the Technical Feasibility of the Procedure, Pathological Results, and Clinical Outcome. Indian J Surg Oncol 9, 442–451 (2018). https://doi.org/10.1007/s13193-018-0808-9

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  • DOI: https://doi.org/10.1007/s13193-018-0808-9

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