INTRODUCTION: Concomitant transanal and transabdominal access has shown potential benefits for patients with lower and medial rectal cancers and led to better short-term and medium-term outcomes, a better quality of surgical specimen and a lower number of positive radial margins. MATERIALS AND METHODS: Between 2015 and 2017, 36 patients with rectal cancer underwent transanal total mesorectal excision (TaTME) surgery. The group included 21 males and 16 females. The mean age of the patients was 68.7 years and ranged from 41 to 83 years. In all cases, concomitant transanal and laparoscopic access via abdomen were used. Transanal access was achieved with the use of GelPoint Path Transanal Access Platform (Applied Medical). The lower rectum was visualized with the use of Lone Star retractor (Lone Star Medical Products Inc.). RESULTS: In 35 cases R0 resection was reported and R1 in 1 case (2.7%). Mean number of lymph nodes in the specimen was 13.7 (8 to 20 nodes). The mesorectal quality was graded as complete in 34 cases (94.4%) and nearly complete in 2 cases (5.6%). Symptoms of anastomotic leak were observed in 6 cases with 3 patients (8.3%) requiring reoperation. CONCLUSIONS: TaTME seems to be a promising method of treatment for patients with lower and middle rectal cancer. Short-term outcomes show an advantage of TaTME over laparoscopic total mesorectal excision.
INTRODUCTION: Concomitant transanal and transabdominal access has shown potential benefits for patients with lower and medial rectal cancers and led to better short-term and medium-term outcomes, a better quality of surgical specimen and a lower number of positive radial margins. MATERIALS AND METHODS: Between 2015 and 2017, 36 patients with rectal cancer underwent transanal total mesorectal excision (TaTME) surgery. The group included 21 males and 16 females. The mean age of the patients was 68.7 years and ranged from 41 to 83 years. In all cases, concomitant transanal and laparoscopic access via abdomen were used. Transanal access was achieved with the use of GelPoint Path Transanal Access Platform (Applied Medical). The lower rectum was visualized with the use of Lone Star retractor (Lone Star Medical Products Inc.). RESULTS: In 35 cases R0 resection was reported and R1 in 1 case (2.7%). Mean number of lymph nodes in the specimen was 13.7 (8 to 20 nodes). The mesorectal quality was graded as complete in 34 cases (94.4%) and nearly complete in 2 cases (5.6%). Symptoms of anastomotic leak were observed in 6 cases with 3 patients (8.3%) requiring reoperation. CONCLUSIONS: TaTME seems to be a promising method of treatment for patients with lower and middle rectal cancer. Short-term outcomes show an advantage of TaTME over laparoscopic total mesorectal excision.