Oncologic results of conventional laparoscopic TME: is the intramesorectal plane really acceptable?

Martínez-Pérez, Aleix; de’Angelis, Nicola

doi:10.1007/s10151-018-1901-3

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…TME is a complex surgical step most commonly performed within rectal resection for colorectal cancer [ 47 ]. This procedure requires dexterity and experience to achieve both oncological radicality and preserve presacral nerves responsible for continence and sexual function [ 48 , 49 , 50 ]. Given that incomplete TME is directly associated with local tumor recurrence and reduced overall survival, TME represents a crucial step in rectal cancer treatment [ 51 , 52 , 53 ].…”

Section: State-of-the-art Of the Intraoperative Application Of Aimentioning

confidence: 99%

Artificial Intelligence in Colorectal Cancer Surgery: Present and Future Perspectives

Quero

Mascagni

Kolbinger

et al. 2022

Cancers

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Artificial intelligence (AI) and computer vision (CV) are beginning to impact medicine. While evidence on the clinical value of AI-based solutions for the screening and staging of colorectal cancer (CRC) is mounting, CV and AI applications to enhance the surgical treatment of CRC are still in their early stage. This manuscript introduces key AI concepts to a surgical audience, illustrates fundamental steps to develop CV for surgical applications, and provides a comprehensive overview on the state-of-the-art of AI applications for the treatment of CRC. Notably, studies show that AI can be trained to automatically recognize surgical phases and actions with high accuracy even in complex colorectal procedures such as transanal total mesorectal excision (TaTME). In addition, AI models were trained to interpret fluorescent signals and recognize correct dissection planes during total mesorectal excision (TME), suggesting CV as a potentially valuable tool for intraoperative decision-making and guidance. Finally, AI could have a role in surgical training, providing automatic surgical skills assessment in the operating room. While promising, these proofs of concept require further development, validation in multi-institutional data, and clinical studies to confirm AI as a valuable tool to enhance CRC treatment.

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Section: State-of-the-art Of the Intraoperative Application Of Aimentioning

confidence: 99%

Artificial Intelligence in Colorectal Cancer Surgery: Present and Future Perspectives

Quero

Mascagni

Kolbinger

et al. 2022

Cancers

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“…The authors discussed that all of them were related to the original disease and not directly to the surgical procedure. A complete TME has become a critical oncologic factor to predict tumor recurrence in the pelvis[ 54 , 55 ]. The quality of TME was reported as near-complete ( n = 12) in four series[ 30 , 32 , 34 , 38 ].…”

Section: Surgical Outcomesmentioning

confidence: 99%

Robotic transanal total mesorectal excision: Is the future now?

Sebastián-Tomás¹,

Martínez-Pérez²,

Martínez-López³

et al. 2021

WJGS

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Total mesorectal excision (TME) is the standard surgical treatment for the curative radical resection of rectal cancers. Minimally invasive TME has been gaining ground favored by the continuous technological advancements. New procedures, such as transanal TME (TaTME), have been introduced to overcome some technical limitations, especially in low rectal tumors, obese patients, and/or narrow pelvis. The earliest TaTME reports showed promising results when compared with the conventional laparoscopic TME. However, recent publications raised concerns regarding the high rates of anastomotic leaks or local recurrences observed in national series. Robotic TaTME (R-TaTME) has been proposed as a novel technique incorporating the potential benefits of a perineal dissection together with precise control of the distal margins, and also offers all those advantages provided by the robotic technology in terms of improved precision and dexterity. Encouraging short-term results have been reported for R-TaTME, but further studies are needed to assess the real role of the new technique in the long-term oncological or functional outcomes. The present review aims to provide a general overview of R-TaTME by analyzing the body of the available literature, with a special focus on the potential benefits, harms, and future perspectives for this novel approach.

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“…The completeness of the mesorectal resection became a valuable item to assess the oncologic safety of a rectal resection and predicts tumor recurrence in the pelvis [72] . Rausa et al [30] showed no significant differences in complete, near-complete or incomplete mesorectal excision between laparoscopic and robotic approaches (complete RR, 0.8; 95%CI: 0.7-1.0; nearly-complete RR, 1.6; 95%CI: 0.9-2.7; incomplete RR, 1.5; 95%CI: 0.8-2.5) [30] .…”

Section: Pathologic Outcomesmentioning

confidence: 99%

Robotic total mesorectal excision: state of the art

Sebastián-Tomás¹,

Santarrufina-Martínez²,

Navarro-Martínez³

et al. 2019

MIS

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Minimally-invasive conventional up-to-down laparoscopic approach is a widespread alternative for rectal cancer resection. Its potential benefits towards open surgery have been shown to rely, however, at secondary clinical outcomes, and its oncological non-inferiority compared with the traditional open approach has not been demonstrated yet. In this scenario, robotic-assisted minimally-invasive rectal resection has gained increasing popularity and promising expectancies. This narrative review aims to assemble the most updated evidence available and to discuss the future perspectives and challenges for this emergent surgical tool. The main benefit over conventional laparoscopy appears to be a reduction of conversion rates to open surgery, whereas the oncologic and functional outcomes seem similar than the other alternatives. Increased costs are the main limitation of the widespread of robotic technology. Low quality of the current evidence is remarkable.

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Oncologic results of conventional laparoscopic TME: is the intramesorectal plane really acceptable?

Cited by 5 publications

References 14 publications

Artificial Intelligence in Colorectal Cancer Surgery: Present and Future Perspectives

Artificial Intelligence in Colorectal Cancer Surgery: Present and Future Perspectives

Robotic transanal total mesorectal excision: Is the future now?

Robotic total mesorectal excision: state of the art

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