Transanal total mesorectal excision in re-operation for anastomosis recurrence rectal cancer

doi:10.16139/j.1007-9610.2023.02.09

Abstract

Abstract:

Objective To investigate the feasibility and safety of transanal total mesorectal excision (TaTME) in re-operation for anastomosis recurrence rectal cancer. Methods Five patients with anastomosis recurrence rectal cancer underwent TaTME at Ruijin Hospital between April 2020 and December 2021 were retrospectively enrolled in this study. The peri-operative situation, pathological examination, and short-term follow-up results were analyzed. Results All cases were operated laparoscopic TaTME successfully. The operative time was (206.00±19.49) min without intraoperative complications. One case encountered incorrect dissection plane. Anastomotic leakage occurred in one case and anastomotic stenosis developed in another case. The specimens quality of mesorectum deemed complete in all cases without both positive circumferential resection margin and positive distal resection margin. There was (15.20±2.39) months of median follow-up and one case found defecation disorder. Tumor recurrence, metastasis and tumor-related death were not found. Conclusions For patients with anastomosis recurrence rectal cancer, laparoscopic TaTME procedure is novel type and would be safe and effective surgical approach with satisfactory short-term follow-up.

Key words: Transanal total mesorectal excision, Rectal cancer, Anastomosis recurrence, Transanal minimal invasive surgery

CLC Number:

R735.37

PAN Linfeng, XU Ximo, Batuer Aikemu, DENG Yang, ZHANG Sen, QIN Wei, SHU Duohuo, CAI Zhenghao, SONG Haiqin, YANG Xiao, ZHONG Hao, HU Yanyan, LI Jianwen, FENG Bo. Transanal total mesorectal excision in re-operation for anastomosis recurrence rectal cancer[J]. Journal of Surgery Concepts & Practice, 2023, 28(02): 132-138.

Figures/Tables 4

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Item	Patient 1	Patient 2	Patient 3	Patient 4	Patient 5
Age (years old)	71	55	63	68	49
Gender	Male	Male	Female	Female	Male
BMI（kg/m²）	23.6	24.3	25.8	26.2	22.9
Distance from anal verge（cm）	6.0	6.5	5.5	5.0	7.0
Tumor diameter（cm）	2.0	2.5	3.0	2.5	2.0
Diabetes	Yes	No	No	No	No
Primary surgery date	2017/10	2018/01	2018/03	2018/07	2018/11
Primary tumor stage	pT₃N₀M₀	pT₃N₁M₀	pT₃N₁M₀	pT₃N₀M₀	pT₃N₁M₀
Primary surgery approach	Open TME	L-TME	L-TME	L-TME	L-TME
Chemotherapy regime	XELOX	XELOX	XELOX	XELOX	XELOX