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Transanal total mesorectal excision (TaTME): single-centre early experience in a selected population

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Abstract

Total mesorectal excision (TME) represents the key principle in the surgical treatment of rectal cancer. Transanal mesorectal excision was introduced as a complement to conventional surgery to overcome its technical difficulties. The aim of this study was to evaluate the early surgical results following the introduction of this novel technique at our Unit. Between January and May 2016, 12 patients diagnosed with mid-low rectal adenocarcinoma were enrolled into this study and evaluated with regards demography, histopathology, peri-operative data and postoperative complications. The tumor was located in the middle rectum in 6 patients (50%), in the lower rectum in 6 patients (50%). Mean operative time was 356.5 ± 76.2 min (range 240–494). Eleven out 12 patients (91.6%) had less than 200 mL of intraoperative blood loss. Mean hospital stay was 10.9 ± 4.6 days (range 5–19). No mortality was recorded. Intraoperative complications were recorded in 1, while early post-operative complications (< 30 days) were observed in 5 patients (41.6%). Histopathology showed in all cases an intact mesorectum. Mean number of lymphnodes harvested was 13.6 ± 6.6 (range 4–29). Distal and circumferential margin was, respectively, of 20.8 ± 14.2 mm (range 2–45 mm) and 16.1 ± 7.6 mm (range 3–30 mm). The comparative analysis showed significant differences concerning mean operative time (p = 0.0473) and estimated blood loss (p = 0.0367). This study confirms this technique is safe and feasible, but more evidence to support its use over conventional laparoscopic surgery is needed.

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Acknowledgements

The authors would like to thank Mr Tan Arulampalam for his precious help with English editing and proofreading.

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Authors and Affiliations

  1. Department of General Surgery, “San Giovanni Battista” Hospital, USL, Umbria 2, Foligno, Perugia, Italy

    Michele De Rosa, Fabio Rondelli, Marcello Boni, Fabio Ermili, Walter Bugiantella, Lorenzo Mariani & Graziano Ceccarelli

  2. Department of Medicine and Health’s Sciences “V. Tiberio”, University of Molise, Campobasso, Italy

    Antonio Giuliani

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  1. Michele De Rosa
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  2. Fabio Rondelli
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  3. Marcello Boni
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  4. Fabio Ermili
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  5. Walter Bugiantella
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  6. Lorenzo Mariani
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  7. Graziano Ceccarelli
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  8. Antonio Giuliani
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Correspondence to Michele De Rosa.

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Conflict of interest

Drs. Michele De Rosa, Fabio Rondelli, Marcello Boni, Fabio Ermili, Walter Bugiantella, Lorenzo Mariani, Graziano Ceccarelli and Antonio Giuliani have no conflicts of interest or financial ties to disclose.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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De Rosa, M., Rondelli, F., Boni, M. et al. Transanal total mesorectal excision (TaTME): single-centre early experience in a selected population. Updates Surg 71, 157–163 (2019). https://doi.org/10.1007/s13304-018-0602-9

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  • DOI: https://doi.org/10.1007/s13304-018-0602-9

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