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Abstract

The transanal approach pioneered for rectal cancer brought to light all of the learning curve issues that could be imagined. As the era of taTME launched, a déjà vu reminiscent of the implementation of laparoscopic cholecystectomy and laparoscopic colorectal surgery and their known early challenges existed. However, the learning curve issues have been clearly appreciated thanks to the taTME registry. Apart from a new set of short-term complications (such as injury to the male urethra) that have been realized, the long-term oncologic safety of the transanal approach still has to be established. The quality of resection with taTME, such as the risk of margin positivity with this technique, is still being established. Furthermore, taTME is unique in that the rectum is intentionally divided or “perforated,” and we are still uncertain about the risk of such specimen perforations as the potential exposure of the dissection area with tumor cells might negatively influence long-term outcomes.

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References

  1. Penna M, Hompes R, Arnold S, Wynn G, Austin R, Warusavitarne J, Moran B, Hanna GB, Mortensen NJ, Tekkis PP, TaTME Registry Collaborative. Transanal total mesorectal excision: international registry results of the first 720 cases. Ann Surg. 2017 Jul;266(1):111–7. https://doi.org/10.1097/SLA.0000000000001948.

    Article  PubMed  Google Scholar 

  2. Penna M, Hompes R, Arnold S, Wynn G, Austin R, Warusavitarne J, Moran B, Hanna GB, Mortensen NJ, Tekkis PP; TaTME Registry Collaborative. Incidence and risk factors for anastomotic failure in 1594 patients treated by transanal total mesorectal excision: results from the international TaTME registry. Ann Surg. 2018. https://doi.org/10.1097/SLA.0000000000002653. [Epub ahead of print].

  3. Lovegrove RE, Heriot AG, Constantinides V, Tilney HS, Darzi AW, Fazio VW, et al. Meta-analysis of short-term and long-term outcomes of J, W and S ileal reservoirs for restorative proctocolectomy. Color Dis [Internet]. 2007 [cited 2017 Jul 31];9(4):310–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/174329.

  4. Lovegrove RE, Constantinides VA, Heriot AG, Athanasiou T, Darzi A, Remzi FH, et al. A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. Ann Surg [Internet]. 2006 [cited 2017 Jul 31];244(1):18–26. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16794385.

  5. Zittan E, Wong-Chong N, Ma GW, McLeod RS, Silverberg MS, Cohen Z. Modified two-stage ileal pouch-anal anastomosis results in lower rate of anastomotic leak compared with traditional two-stage surgery for ulcerative colitis. J Crohns Colitis [Internet]. 2016 [cited 2017 Jul 31];10(7):766–72.

    Google Scholar 

  6. Sahami S, Bartels SAL, D’Hoore A, Fadok TY, Tanis PJ, Lindeboom R, et al. A multicentre evaluation of risk factors for anastomotic leakage after restorative proctocolectomy with ileal pouch-anal anastomosis for inflammatory bowel disease. J Crohns Colitis [Internet]. 2016 [cited 2017 Jul 31];10(7):773–8.

    Google Scholar 

  7. Bartels SAL, DʼHoore A, Cuesta MA, Bensdorp AJ, Lucas C, Bemelman WA. Significantly increased pregnancy rates after laparoscopic restorative proctocolectomy. Ann Surg [Internet]. 2012 [cited 2017 Jul];256(6):1045–8.

    Google Scholar 

  8. Kim JH, Kim HY, Lee IK, Oh ST, Kim JG, Lee YS. Intra-operative double-stapled colorectal or coloanal anastomotic complications of laparoscopic low anterior resection for rectal cancer: double-stapled anastomotic complication could result in persistent anastomotic leakage. Surg Endosc. 2015;29(11):3117–24. https://doi.org/10.1007/s00464-014-4035-3. Epub 2014 Dec 18

    Article  PubMed  Google Scholar 

  9. Roumen RM, Rahusen FT, Wijnen MH, Croiset van Uchelen FA. “Dog ear” formation after double-stapled low anterior resection as a risk factor for anastomotic disruption. Dis Colon Rectum. 2000;43(4):522–5.

    Article  CAS  PubMed  Google Scholar 

  10. Bartels SAL, Gardenbroek TJ, Aarts M, Ponsioen CY, Tanis PJ, Buskens CJ, et al. Short-term morbidity and quality of life from a randomized clinical trial of close rectal dissection and total mesorectal excision in ileal pouch-anal anastomosis. Br J Surg [Internet]. 2015 [cited 2017 Jun 30];102(3):281–7.

    Google Scholar 

  11. Verlaan T, Bartels SA, van Berge Henegouwen MI, Tanis PJ, Fockens P, Bemelman WA. Early, minimally invasive closure of anastomotic leaks: a new concept. Color Dis. 2011;13(Suppl 7):18–22. https://doi.org/10.1111/j.1463-1318.2011.02775.

    Article  Google Scholar 

  12. Gardenbroek TJ, Musters GD, Buskens CJ, Ponsioen CY, D’Haens GRAM, Dijkgraaf MGW, et al. Early reconstruction of the leaking ileal pouch-anal anastomosis: a novel solution to an old problem. Color Dis. 2015;17(5):426–32. https://doi.org/10.1111/codi.12867.

    Article  CAS  Google Scholar 

  13. de Buck van Overstraeten A, Mark-Christensen A, Wasmann KA, Bastiaenen VP, Buskens CJ, Wolthuis AM, Vanbrabant K, D’hoore A, Bemelman WA, Tottrup A, Tanis PJ. Transanal versus transabdominal minimally invasive (completion) proctectomy with ileal pouch-anal anastomosis in ulcerative colitis: a comparative study. Ann Surg. 2017;266(5):878–83.

    Article  PubMed  Google Scholar 

  14. van der Ploeg VA, Maeda Y, Faiz OD, Hart AL, Clark SK. The prevalence of chronic peri-pouch sepsis in patients treated for antibiotic-dependent or refractory primary idiopathic pouchitis. Color Dis. 2017;19(9):827–31. https://doi.org/10.1111/codi.13536.

    Article  Google Scholar 

  15. Lightner AL, Shogan BD, Mathis KL, Larson DW, Duchalais E, Pemberton JH, Dozois EJ. Revisional and reconstructive surgery for failing IPAA is associated with good function and pouch salvage in highly selected patients. Dis Colon Rectum. 2018;61(8):920–30.

    PubMed  Google Scholar 

  16. Litzendorf ME, Stucchi AF, Wishnia S, Lightner A, Becker JM. Completion mucosectomy for retained rectal mucosa following restorative proctocolectomy with double-stapled ileal pouch-anal anastomosis. J Gastrointest Surg [Internet]. 2010 [cited 2017 Aug 1];14(3):562–9.

    Google Scholar 

  17. Remzi FH, Aytac E, Ashburn J, Gu J, Hull TL, Dietz DW, et al. Transabdominal redo ileal pouch surgery for failed restorative proctocolectomy. Ann Surg [Internet]. 2015 [cited 2017 Aug 1];262(4):675–82. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26366548.

  18. Mathis KL, Dozois EJ, Larson DW, Cima RR, Wolff BG, Pemberton JH. Outcomes in patients with ulcerative colitis undergoing partial or complete reconstructive surgery for failing ileal pouch-anal anastomosis. Ann Surg [Internet]. 2009 [cited 2017 Aug 1];249(3):409–13. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19247027.

  19. Garrett KA, Remzi FH, Kirat HT, Fazio VW, Shen B, Kiran RP. Outcome of salvage surgery for ileal pouches referred with a diagnosis of Crohnʼs disease. Dis Colon Rectum [Internet]. 2009 [cited 2017 Aug 1];52(12):1967–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19934917.

  20. Theodoropoulos GE, Choman EN, Wexner SD. Salvage procedures after restorative proctocolectomy: a systematic review and meta-analysis. J Am Coll Surg [Internet]. 2015 [cited 2017 Aug 1];220(2):225–242.e1.

    Google Scholar 

  21. Borstlap WAA, Harran N, Tanis PJ, Bemelman WA. Feasibility of the TAMIS technique for redo pelvic surgery. Surg Endosc [Internet]. 2016 [cited 2017 Aug 1];30(12):5364–71. Available from: http://link.springer.com/10.1007/s00464-016-4889-7.

  22. de Groof EJ, van der Meer JHM, Tanis PJ, de Bruyn JR, van Ruler O, D’Haens GRAM, van den Brink GR, Bemelman WA, Wildenberg, ME, Buskens CJ. Persistent mesorectal inflammatory activity is associated with complications after proctectomy in Crohn’s disease. JCC accepted. J Crohns Colitis 2018, Sept online.

    Google Scholar 

  23. Borstlap WAA, Westerduin E, Aukema TS, Bemelman WA, Tanis PJ, Dutch Snapshot Research Group. Anastomotic leakage and chronic presacral sinus formation after low anterior resection: results from a large cross-sectional study. Ann Surg. 2017;266(5):870–7. https://doi.org/10.1097/SLA.0000000000002429.

    Article  PubMed  Google Scholar 

  24. Sloothaak DA, Buskens CJ, Bemelman WA, Tanis PJ. Treatment of chronic presacral sinus after low anterior resection. Color Dis. 2013;15(6):727–32. https://doi.org/10.1111/codi.12094.

    Article  CAS  Google Scholar 

  25. Westerduin E, Borstlap WAA, Musters GD, Westerterp M, van Geloven AAW, Tanis PJ, Wolthuis AM, Bemelman WA, D’Hoore A. Redo coloanal anastomosis for anastomotic leakage after low anterior resection for rectal cancer: an analysis of 59 cases. Color Dis. 2018;20(1):35–43. https://doi.org/10.1111/codi.13844.

    Article  CAS  Google Scholar 

  26. Westerduin E, Bos K, Blok RD, Tanis PJ, Bemelman WA. Transanal minimal invasive surgery for anastomotic reconstruction or salvage surgery after low anterior resection for rectal cancer. Diseases of the Colon and Rectum 2019.

    Google Scholar 

  27. Atallah S, Dubose A, Larach S. Vaginal access minimally invasive surgery for repair of a postanastomotic rectovaginal fistula: a video description of a novel method. Dis Colon Rectum. 2017;60(1):126–7.

    Article  PubMed  Google Scholar 

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Correspondence to Willem A. Bemelman .

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Bemelman, W.A. (2019). Indications for Benign Disease of the Rectum. In: Atallah, S. (eds) Transanal Minimally Invasive Surgery (TAMIS) and Transanal Total Mesorectal Excision (taTME). Springer, Cham. https://doi.org/10.1007/978-3-030-11572-2_20

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  • DOI: https://doi.org/10.1007/978-3-030-11572-2_20

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