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Transanal total mesorectal excision assisted by single-port laparoscopic surgery for low rectal cancer

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Abstract

Introduction

We have combined the minimally invasive single-port laparoscopic surgery and the transanal total mesorectal excision (TaTME) for rectal cancer with the goal to standardize the approach and improve the quality of rectal cancer resection.

Methods

By using two single-port platforms, selected patients were first operated by TaTME, and then a single-port laparoscopic surgery was introduced to assist and complete the abdominal portion. Short-term outcomes including perioperative outcome and pathologic results of these patients were evaluated.

Results

Between July 2014 and March 2015, six patients with low rectal cancer (five males and one female) at a median age of 68 years were successfully operated in a median time of 360 min (range 310–420). The median estimated blood loss was 150 ml (range 50–800). In one patient, the spleen was removed because of a lesion identified preoperatively. Their postoperative recovery was uneventful except one acute myocardial infarction on postoperative day 3. Pathologic specimens showed negative margins and a complete excision of the mesorectum in all cases. The median number of harvested lymph nodes was 11.5 (range 4–12). At a median follow-up of 4 months (range 3–9), after ileostomy closure, none of the patients suffered from fecal incontinence.

Conclusion

TaTME assisted by abdominal single-port may be safely achieved in selected rectal cancer patients.

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Corresponding author

Correspondence to J.-P. Wang.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and with the ethical standards of Helsinki declaration.

Informed consent

Informed consent was obtained from all individual participants included in the study. Patients also gave permission for publication of technique and results.

Additional information

W.-H. Chen and L. Kang contributed equally to this work and share the first author.

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Chen, WH., Kang, L., Luo, SL. et al. Transanal total mesorectal excision assisted by single-port laparoscopic surgery for low rectal cancer. Tech Coloproctol 19, 527–534 (2015). https://doi.org/10.1007/s10151-015-1342-1

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  • DOI: https://doi.org/10.1007/s10151-015-1342-1

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