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Rectal Carcinoma: Operative Treatment, Transanal

  • Cora Ianiro
  • Mark H. Whiteford
  • Patricia SyllaEmail author
Chapter

Abstract

The evolution of transanal local excision techniques was driven by the need for less invasive alternatives to radical rectal cancer resections, particularly in the management of early rectal tumors. Over the last 3 decades, conventional transanal excision through standard anoscopes has been supplanted by transanal endoluminal techniques through the use of transanal endoscopic platforms, collectively referred to as transanal endoscopic surgery (TES). Transanal endoscopic microsurgery (TEM) and was originally designed to perform submucosal or full-thickness local resection of rectal adenomas, but its use has since expanded to include the curative resection of appropriately selected early-stage rectal cancer. The advent of natural orifice transluminal endoscopic surgery (NOTES) combines the advantages of earlier techniques such as laparoscopic and robotic procedures, with respect to reduced incision size and oncological adequacy for total mesorectal excision (TME) for rectal surgery. In this chapter, current indications and contraindications for TES and taTME in the treatment of rectal cancer will be discussed, in addition to current obstacles, patient selection, preoperative preparation perioperative considerations, and complications.

Keywords

Transanal excision (TAE) Transanal endoscopic surgery (TES) Transanal endoscopic microsurgery (TEM) Transanal endoscopic operation system (TEO) Transanal minimally invasive surgery (TAMIS) Rectal cancer transluminal endoscopic surgery (NOTES) transanal total mesorectal excision (taTME) 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Cora Ianiro
    • 1
  • Mark H. Whiteford
    • 2
  • Patricia Sylla
    • 1
    • 3
    Email author
  1. 1.Department of Surgery, Division of Colorectal SurgeryMount Sinai HospitalNew YorkUSA
  2. 2.Oregon Health and Science UniversityPortlandUSA
  3. 3.Icahn School MedicineNew YorkUSA

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