Transanal total mesorectal excision and transabdominal robotic surgery for rectal cancer: A retrospective study
| Autor: | Hiroaki Musha, Hiroshi Oshio, Masaaki Kawai, Yuya Ashitomi, Shinji Okazaki, Fuyuhiko Motoi, Gen Yunome, Ichiro Kawamura, Yukiko Oshima |
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| Rok vydání: | 2021 |
| Předmět: |
Laparoscopic surgery
medicine.medical_specialty business.industry Colorectal cancer medicine.medical_treatment Robotic surgery General Medicine medicine.disease Total mesorectal excision Surgery Ileostomy medicine.anatomical_structure Medicine Rectal cancer Transanal total mesorectal excision (TaTME) business Coloanal anastomosis Lymph node Neoadjuvant therapy Hybrid surgery Case-controlled Study |
| Zdroj: | Annals of Medicine and Surgery |
| ISSN: | 2049-0801 |
| Popis: | Background Transabdominal robotic surgery and transanal total mesorectal excision (TaTME) are newly introduced strategies for rectal cancer. These procedures might have many advantages in rectal cancer treatment in terms of improving oncological and functional outcomes, especially in cases involving advanced cancer or technical difficulty. In the present study, we aimed to clarify the advantages and disadvantages of transabdominal robotic surgery and laparoscopic TaTME as a hybrid surgery for rectal cancer. Materials and methods We retrospectively evaluated six patients who underwent hybrid surgery for rectal cancer from August 2018 to April 2020. Both clinical and pathological outcomes were assessed. Results Two patients showed circumferential margin involvement both before and after neoadjuvant therapy. Three patients were planned to undergo hybrid surgery with intersphincteric resection because of a narrow pelvis. One patient was planned to undergo hybrid surgery for a giant tumor of >10 cm. The median length of hospitalization was 17 days. No patients required conversion to an open procedure. All patients underwent formation of defunctioning ileostomies. Two patients had a stapled anastomosis and four had a hand-sewn coloanal anastomosis. Complications included one case of anastomotic leakage, which was managed conservatively with ultrasound- and computed tomography-guided drainage and antibiotics. Histological analysis revealed that all specimens had a negative radial margin and distal margin. The median number of lymph nodes harvested was 17.5. Two patients showed extensive lymph node metastases, including lateral node metastasis. Conclusion Hybrid surgery was performed safely and may improve oncological outcomes for rectal cancer. This technique has many potential benefits and would be alternative option in multimodal strategies for rectal cancer. Highlights • No studies to date have focused on treatment of locally advanced rectal cancer in men using intersphincteric resection hybrid technology involving transabdominal robotic surgery with conventional transanal total mesorectal excision. • We found that hybrid surgery is feasible and may improve the quality of total mesorectal excision and the rate of radical resection for advanced rectal cancer. • Hybrid surgery may improve urinary and sexual function. • This technique has many potential benefits and would be an alternative approach for rectal cancer. |
| Databáze: | OpenAIRE |
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