F Borja de Lacy1, Deborah Susan Keller2, Beatriz Martin-Perez3, Sameh Hany Emile4, Manish Chand5, Antonino Spinelli6, Antonio M Lacy3. 1. Department of Surgery, Hospital Clinic, University of Barcelona, Villarroel, 170, 08036, Barcelona, Spain. bdelacy@aischannel.com. 2. Division of Colon and Rectal Surgery, Department of Surgery, NewYork-Presbyterian, Columbia University Medical Center, New York, NY, USA. 3. Department of Surgery, Hospital Clinic, University of Barcelona, Villarroel, 170, 08036, Barcelona, Spain. 4. General Surgery Department, Mansoura Faculty of Medicine, Mansoura, Egypt. 5. Department of Gastroenterological Intervention, University College London, City of London, UK. 6. Division Colon and Rectal Surgery, Humanitas Research Hospital, Humanitas University Rozzano Milano, Milano, Italy.
Abstract
BACKGROUND: The transanal approach to pelvic dissection has gained considerable traction and utilization continues to expand, fueled by the transanal total mesorectal excision (TaTME) for rectal cancer. The same principles and benefits of transanal pelvic dissection may apply to the transanal restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA)-the TaPouch procedure. Our goal was to review the literature to date on the development and current state of the TaPouch. MATERIALS AND METHODS: We performed a PubMed database search for original articles on transanal pelvic dissections, IPAA, and the TaPouch procedure, with a manual search from relevant citations in the reference list. The main outcomes were the technical aspects of the TaPouch, clinical and functional outcomes, and potential advantages, drawbacks, and future direction for the procedure. RESULTS: The conduct of the procedure has been defined, with the safety and feasibility demonstrated in small series. The reported rates of conversion and anastomotic leakage are low. There are no randomized trials or large-scale comparative studies available for comparative effectiveness compared to the traditional IPAA. CONCLUSIONS: The transanal approach to ileal pouch-anal anastomosis is an exciting adaption of the transanal total mesorectal excision for refining the technical steps of a complex operation. Additional experience is needed for comparative outcomes and defining the ideal training and implementation pathways.
BACKGROUND: The transanal approach to pelvic dissection has gained considerable traction and utilization continues to expand, fueled by the transanal total mesorectal excision (TaTME) for rectal cancer. The same principles and benefits of transanal pelvic dissection may apply to the transanal restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA)-the TaPouch procedure. Our goal was to review the literature to date on the development and current state of the TaPouch. MATERIALS AND METHODS: We performed a PubMed database search for original articles on transanal pelvic dissections, IPAA, and the TaPouch procedure, with a manual search from relevant citations in the reference list. The main outcomes were the technical aspects of the TaPouch, clinical and functional outcomes, and potential advantages, drawbacks, and future direction for the procedure. RESULTS: The conduct of the procedure has been defined, with the safety and feasibility demonstrated in small series. The reported rates of conversion and anastomotic leakage are low. There are no randomized trials or large-scale comparative studies available for comparative effectiveness compared to the traditional IPAA. CONCLUSIONS: The transanal approach to ileal pouch-anal anastomosis is an exciting adaption of the transanal total mesorectal excision for refining the technical steps of a complex operation. Additional experience is needed for comparative outcomes and defining the ideal training and implementation pathways.
Authors: Anthony de Buck van Overstraeten; Anders Mark-Christensen; Karin A Wasmann; Vivian P Bastiaenen; Christianne J Buskens; Albert M Wolthuis; Koen Vanbrabant; André D'hoore; Willem A Bemelman; Anders Tottrup; Pieter J Tanis Journal: Ann Surg Date: 2017-11 Impact factor: 12.969
Authors: Nicolas C Buchs; Gary A Nicholson; Frederic Ris; Neil J Mortensen; Roel Hompes Journal: World J Gastroenterol Date: 2015-11-07 Impact factor: 5.742