Robotic or transanal total mesorectal excision (TaTME) approach for rectal cancer, how about both? Feasibility and outcomes from a single institution

Inoue, Yusuke; Ng, Jing Yu; Chu, Chun Ho; Lai, Yanhao; Huang, I-Ping; Yang, Shung Haur; Chen, Chien Chih

doi:10.1007/s11701-021-01206-7

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…Based on the belief that incorporating the advantages of each of these techniques could achieve a safer and less invasive surgery and, consequently, better oncological outcomes, we established hybrid TaTME at our institution. To our knowledge, few reports of this technique have been published [21][22][23][24], and the present study is the first to compare it with conventional TaTME regarding safety and feasibility. We found that the short-term outcomes of hybrid TaTME were comparable to those of conventional TaTME, which was considered acceptable.…”

Section: Discussionmentioning

confidence: 88%

“…Since June 2020, we have performed TaTME in combination with the abdominal robotic approach (hybrid TaTME) for a safer, less invasive surgery. Because reports on this technique are scarce, the feasibility and safety of hybrid TaTME are unclear [21][22][23][24]. Therefore, this study evaluated the feasibility and safety of hybrid TaTME compared with conventional TaTME for low rectal cancer.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and safety of robotic surgery for low rectal cancer combined with transanal total mesorectal excision

Ando

Matsuda

Sawada

et al. 2023

Langenbecks Arch Surg

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Purpose Laparoscopic surgery for low rectal cancer is often challenging. Transanal total mesorectal excision (TaTME) and robotic surgery have been introduced to overcome the technical difficulties in laparoscopic surgery and achieve more favorable outcomes. Hybrid robotic surgery, which combines TaTME with the abdominal robotic approach, incorporates the advantages of each of these surgical techniques and might achieve less invasive and safer surgery. This study evaluated the safety and feasibility of hybrid robotic surgery with TaTME (hybrid TaTME). Methods We retrospectively reviewed 162 TaTME cases performed at our department from September 2016 to May 2022. Among them, 92 cases of conventional TaTME and 30 of hybrid TaTME were eligible. We used propensity score matching analysis (PSM) to adjust for patients’ characteristics and compared the short-term outcomes of the two treatment groups. Results Twenty-seven cases in each group were extracted using PSM. The operation time in hybrid TaTME was comparable to that in conventional TaTME. There was no significant difference in the postoperative hospital stay between the two groups. Other intra- and post-operative outcomes were also comparable between the two groups. Furthermore, no significant differences were observed between the two groups in the curative resection and recurrence rates. Conclusion Hybrid TaTME for low rectal cancer was as favorable as conventional TaTME in producing satisfactory short-term outcomes. However, furthermore, larger-scale studies conducted over longer study periods are needed to evaluate the validity of the findings.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Feasibility and safety of robotic surgery for low rectal cancer combined with transanal total mesorectal excision

Ando

Matsuda

Sawada

et al. 2023

Langenbecks Arch Surg

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“…The TNM classification was determined according to the criteria of the American Joint Commission on Cancer (AJCC) and International Union Against Cancer (UICC) [ 23 ]. Intraoperative safety measures pertained to events that occurred during the surgery, specifically death during surgery, surgical procedures [ 16 , 17 , 24 , 25 , 26 ], and conversion to open surgery, and various measures, specifically docking time, operation time, console time, estimated blood loss, and blood transfusion, were collected. Postoperative clinical outcomes were analyzed for predischarge and postdischarge periods, including LOS, rehospitalization within the 30-day postoperative period, reoperation within the 30-day postoperative period, and death within the 30-day postoperative period.…”

Section: Methodsmentioning

confidence: 99%

Clinical Safety and Effectiveness of Robotic-Assisted Surgery in Patients with Rectal Cancer: Real-World Experience over 8 Years of Multiple Institutions with High-Volume Robotic-Assisted Surgery

Huang

Wei

Chen

et al. 2022

Cancers

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The perioperative and short-term oncological outcomes of robotic-assisted rectal surgery (RRS) are unclear. This retrospective observational study enrolled patients with rectal adenocarcinoma undergoing RRS from three high-volume institutions in Taiwan. Of the 605 enrolled patients, 301 (49.75%), 176 (29.09%), and 116 (19.17%) had lower, middle, and upper rectal cancers, respectively. Low anterior resection (377, 62.31%) was the most frequent surgical procedure. Intraoperative blood transfusion was performed in 10 patients (2%). The surgery was converted to an open one for one patient (0.2%), and ten (1.7%) patients underwent reoperation. The overall complication rate was 14.5%, including 3% from anastomosis leakage. No deaths occurred during surgery and within 30 days postoperatively. The positive rates of distal resection margin and circumferential resection margin were observed in 21 (3.5%) and 30 (5.0%) patients, respectively. The 5-year overall and disease-free survival rates for patients with stage I–III rectal cancer were 91.1% and 86.3%, respectively. This is the first multi-institutional study in Taiwan with 605 patients from three high-volume hospitals. The overall surgical and oncological outcomes were equivalent or superior to those estimated in other studies. Hence, RRS is an effective and safe technique for rectal resection in high-volume hospitals.

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“…Beyond the learning curve, the TaTME movement progresses unabated. The combined use of both robotic assisted surgery and TaTME has already been described [ 38 ]. Robotic TaTME has also been introduced as a novel technique, incorporating both the benefits of TaTME and use of robotic technology [ 39 ].…”

Section: Mounting the Curvementioning

confidence: 99%

Transanal total mesorectal excision for rectal cancer: it’s come a long way and here to stay

2022

Ann Coloproctol

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Transanal total mesorectal excision (TaTME) was introduced as a novel technique to deal with rectal cancers. Its transanal approach offered the shortest distance to approach a challenging location, allowing an excellent visualization of the distal resection margin. Since its introduction in 2010, a significant amount of research has been put in to measure its development. In this review, we look at its ancestry, the genesis for its introduction and continued evolution as well as some of the important outcomes in its journey thus far. The importance of a structured and proctored learning journey is also stressed to enable the safe application and development of this technique. Beyond this, the TaTME movement has progressed relentlessly and its utility has been expanded to the management of benign conditions such as inflammatory bowel disease, Hartman reversals, and anastomotic strictures. We believe that the continued development and adoption of TaTME worldwide is here to stay.

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Robotic or transanal total mesorectal excision (TaTME) approach for rectal cancer, how about both? Feasibility and outcomes from a single institution

Cited by 5 publications

References 33 publications

Feasibility and safety of robotic surgery for low rectal cancer combined with transanal total mesorectal excision

Feasibility and safety of robotic surgery for low rectal cancer combined with transanal total mesorectal excision

Clinical Safety and Effectiveness of Robotic-Assisted Surgery in Patients with Rectal Cancer: Real-World Experience over 8 Years of Multiple Institutions with High-Volume Robotic-Assisted Surgery

Transanal total mesorectal excision for rectal cancer: it’s come a long way and here to stay

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