Transanal total mesorectal excision and transabdominal robotic surgery for rectal cancer: A retrospective study

Oshio, Hiroshi; Oshima, Yutaka; Yunome, Gen; Okazaki, Satoshi; Kawamura, Ichiro; Ashitomi, Yuya; Musha, Hiroaki; Kawai, Masaaki; Motoi, Fuyuhiko

doi:10.1016/j.amsu.2021.102902

Cited by 4 publications

(6 citation statements)

References 47 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 – 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: 97%

“…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: 97%

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 mean operation time was 340 minutes in the previous cases mentioned in Table 1 . Currently, at our hospital, TaTME is indicated for difficult surgical cases of advanced rectal cancer after preoperative chemotherapy and for male intersphincteric resection cases [ 14 ]. However, we have now expanded the indication for TaTME to include ulcerative colitis lesions that might be cancerous.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Proctocolectomy With Transanal Total Mesorectal Excision for Ulcerative Colitis

Ashitomi¹,

Oshio²,

Yano³

et al. 2021

Cureus

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Transanal total mesorectal excision (TaTME) refers to endoscopic retrograde total mesorectal excision and is becoming increasingly popular worldwide. TaTME improves surgical manipulation and minimizes the risk of local recurrence of rectal cancer by ensuring circumferential resection margins. TaTME is mainly indicated for patients in whom transabdominal approaches are expected to be technically challenging. We extended the indications for TaTME to include surgery for ulcerative colitis lesions that might be cancerous in the rectum. Here, we report a case of proctocolectomy with TaTME for ulcerative colitis. A 38-year-old woman who was receiving treatment for ulcerative colitis underwent a biopsy for random samples from the transverse colon to the rectum. Histopathological findings revealed noninvasive dysplasia with p53 overexpression, suggestive of cancer. We extended the indication of TaTME to surgery for ulcerative colitis. We formed two surgical teams and performed laparoscopic proctocolectomy with TaTME simultaneously. This simultaneous operation reduced the duration of the procedures in the present case. The patient was discharged without any complications and underwent loop ileostomy closure four months postoperatively. The patient recovered without significant loss of the anal sphincter function and is doing well four months after the second surgery. We propose laparoscopic proctocolectomy with TaTME to be conducted simultaneously by two teams as a safe and effective technique that is associated with a shorter operation time than that reported previously. Additionally, TaTME was useful in confirming the appropriate dissection layer as well as in surgical manipulation. Hence, TaTME could serve as a useful therapeutic option for ulcerative colitis surgery.

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“…Robot-assisted total mesorectal excision (TME) and trans-anal TME (TaTME) are important surgical strategies for rectal cancer [ 1 , 2 ], with advantages for improving oncological and functional outcomes [ 1–3 ]. Hybrid surgery, which comprises an abdominal robotic approach with TaTME, has been reported as a novel strategy for securing surgical margin in cases involving advanced cancer or technical difficulties [ 4 , 5 ]. Herein, we describe a case of hybrid robot-assisted abdominoperineal resection (APR), supported by the trans-perineal approach, for anal gland adenocarcinoma with vaginal invasion.…”

Section: Introductionmentioning

confidence: 99%

Hybrid robot-assisted abdominoperineal resection supported by simultaneous trans-perineal approach for anal gland adenocarcinoma with vaginal invasion: a case report

Imaizumi

Kasajima

Ito

et al. 2023

Journal of Surgical Case Reports

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Hybrid surgery (abdominal robotic approach with a trans-anal approach) has been reported to improve oncological outcomes in cases involving advanced cancer or technical difficulties. A 74-year-old woman presented with anal pain and stenosis. Examination revealed palpable sclerosis on the anterior wall at the anal verge with possible vaginal invasion. A biopsy revealed an adenocarcinoma. We performed a two-team robot-assisted abdominoperineal resection combined with resection of the vagina supported by a simultaneous trans-perineal approach. After rendezvous at the posterior side, the abdominal team cut the posterior wall of the vaginal vault while the perineal team confirmed the surgical margin. Histopathological findings identified the tumour as an anal gland adenocarcinoma (pT4b [vagina] N0M0 pathological stage IIC) with a negative circumferential resection margin. Hybrid surgery combined with resection of the posterior wall of the vagina may be performed safely and is a valuable surgical option for multimodal treatment of anal adenocarcinomas.

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Transanal total mesorectal excision and transabdominal robotic surgery for rectal cancer: A retrospective study

Cited by 4 publications

References 47 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

Laparoscopic Proctocolectomy With Transanal Total Mesorectal Excision for Ulcerative Colitis

Hybrid robot-assisted abdominoperineal resection supported by simultaneous trans-perineal approach for anal gland adenocarcinoma with vaginal invasion: a case report

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