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Rectal cancer treatment by transanal total mesorectal excision: Results in 100 consecutive patients.
- Source :
-
Cirugia espanola [Cir Esp (Engl Ed)] 2019 Nov; Vol. 97 (9), pp. 510-516. Date of Electronic Publication: 2019 Jul 24. - Publication Year :
- 2019
-
Abstract
- Introduction: The aim of this study is to describe and evaluate our clinical short-term surgical results of laparoscopic transanal total mesorectal excision.<br />Methods: Analysis of 100 consecutive patients with mid and lower rectal cancer who underwent transanal total mesorectal excision from November 2013 to September 2018. Main outcomes described are operative data, morbidities, mortality and quality of the specimen. A comparative analysis was done between gender and simultaneous vs. non simultaneous abdominal-perineal surgery.<br />Results: Mean patient age was 67 years (56-75), and 67% were male. On MRI, 50% were stage T3 tumors, and 52% had positive nodes. Mean distance of the tumor from anal verge was 4.9±1.3cm. A total of 58% underwent neoadjuvant treatment. Mean operative time was 262±40.7min; it was shorter in females (P<.001) and in simultaneous 2-field surgery. Median specimen distal free margin was 1.5cm (0.5-2.4). A total of 89% of the specimens were with complete mesorectum, with better results when a simultaneous approach was used (P=.047). The mean number of retrieved lymph-nodes was 15.2±11.6, and 26% of patients had positive nodes. Median length of stay was 5.5 days (4-8). Morbidities occurred in 36% of cases, and one patient died.<br />Conclusions: According to our experience, laparoscopic transanal total mesorectal excision is safe and effective with adequate circumferential and distal free margins and high quality of the resected mesorectum specimen. Post-operative morbidity is acceptable, according to the current literature.<br /> (Copyright © 2019 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Subjects :
- Aged
Anal Canal surgery
Female
Humans
Laparoscopy methods
Length of Stay
Male
Margins of Excision
Middle Aged
Minimally Invasive Surgical Procedures adverse effects
Neoadjuvant Therapy methods
Neoplasm Staging
Operative Time
Rectal Neoplasms mortality
Rectum pathology
Retrospective Studies
Transanal Endoscopic Surgery adverse effects
Minimally Invasive Surgical Procedures methods
Rectal Neoplasms surgery
Rectum surgery
Transanal Endoscopic Surgery methods
Subjects
Details
- Language :
- English; Spanish; Castilian
- ISSN :
- 2173-5077
- Volume :
- 97
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Cirugia espanola
- Publication Type :
- Academic Journal
- Accession number :
- 31351576
- Full Text :
- https://doi.org/10.1016/j.ciresp.2019.05.014