Background:Although the anatomic difficulties of laparoscopic surgery for rectal cancer have been resolved by hybrid transanal total mesorectal excision(h-taTME),a completely incisionless surgical procedure has not ye...Background:Although the anatomic difficulties of laparoscopic surgery for rectal cancer have been resolved by hybrid transanal total mesorectal excision(h-taTME),a completely incisionless surgical procedure has not yet been developed.This study was performed to explore the efficacy of pure taTME(p-taTME)without laparoscopic assistance as a completely non-invasive surgical procedure for rectal cancer.Methods:We retrospectively evaluated all patients with rectal cancer who underwent p-taTME between December 2015 and April 2018.Relevant patient characteristics and clinical information including the surgical procedure,specimens,pathological characteristics,and patients’post-operative state were analysed and the feasibility of p-taTME in patients with rectal cancer was assessed.Results:Fifty-five patients who had undergone p-taTME were included in this study.They comprised 32(58.2%)men and 23(41.8%)women with a mean age of 65.6610.6 years and mean body mass index of 23.463.3 kg/m^(2).The median surgical time was 180.0(range,130–360)min and estimated blood loss was 25.0(range,15–80)mL.The commonest post-operative complication was varying degrees of faecal incontinence(56.4%).However,such incontinence greatly improved after pelvic-floor-function-rehabilitation exercises and did not seriously affect the patients’quality of life.Conclusions:p-taTME is a relatively safe and incisionless procedure for patients with middle and low rectal cancer,especially in those with obesity or a narrow pelvis.However,further studies of the indications and long-termefficacy are needed to verify the suitability of this procedure.展开更多
文摘Background:Although the anatomic difficulties of laparoscopic surgery for rectal cancer have been resolved by hybrid transanal total mesorectal excision(h-taTME),a completely incisionless surgical procedure has not yet been developed.This study was performed to explore the efficacy of pure taTME(p-taTME)without laparoscopic assistance as a completely non-invasive surgical procedure for rectal cancer.Methods:We retrospectively evaluated all patients with rectal cancer who underwent p-taTME between December 2015 and April 2018.Relevant patient characteristics and clinical information including the surgical procedure,specimens,pathological characteristics,and patients’post-operative state were analysed and the feasibility of p-taTME in patients with rectal cancer was assessed.Results:Fifty-five patients who had undergone p-taTME were included in this study.They comprised 32(58.2%)men and 23(41.8%)women with a mean age of 65.6610.6 years and mean body mass index of 23.463.3 kg/m^(2).The median surgical time was 180.0(range,130–360)min and estimated blood loss was 25.0(range,15–80)mL.The commonest post-operative complication was varying degrees of faecal incontinence(56.4%).However,such incontinence greatly improved after pelvic-floor-function-rehabilitation exercises and did not seriously affect the patients’quality of life.Conclusions:p-taTME is a relatively safe and incisionless procedure for patients with middle and low rectal cancer,especially in those with obesity or a narrow pelvis.However,further studies of the indications and long-termefficacy are needed to verify the suitability of this procedure.
