Transanal total mesorectal excision for rectal cancer: early outcomes in 50 consecutive patients
Transanal total mesorectal excision for rectal cancer: early outcomes in 50 consecutive patients
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DOI：
10.1111/codi.13263
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发表时间：
2016-06-01
影响因子：
3.4
通讯作者：
Atallah, S.
中科院分区：
文献类型：
--
作者：
Burke, J. P.;Martin-Perez, B.;Atallah, S.
目的直肠癌微创切除术由于其固有的技术挑战尚未被广泛采用。传统经腹游离术的改良，称为经肛门全直肠系膜切除术（TaTME），有可能改善远端直肠的进入。本研究的目的是评估以下TaTME直肠cancer.MethodThis的结果是一个前瞻性的数据库，连续患者谁接受TaTME直肠癌在一个单一的机构进行回顾性分析。研究时间为2012年3月1日至2015年7月31日。肿瘤距肛缘的中位距离为4.4（3.0-5.5）cm。从计划的微创入路的转换率为2.2%。中位手术时间为267.0（227.0-331.0）min，中位淋巴结转移率为18.0（12.0-23.8），切除标本的大体质量评估不完整率为2%，环切缘阳性率为4%。术中发病率为6%，30天发病率为36%。中位住院时间为4.5（4.0-8.0）天。中位随访时间为15.1（7.0-23.2）个月; 2例患者已开发的局部复发和8例已开发的远端recursion.ConclusionThese数据表明，TaTME直肠癌是可行的，可接受的病理结果和发病率的档案。需要更多关于功能和长期生存结局的数据。
AimMinimally invasive approaches to proctectomy for rectal cancer have not been widely adopted due to inherent technical challenges. A modification of traditional transabdominal mobilization, termed transanal total mesorectal excision (TaTME), has the potential to improve access to the distal rectum. The aim of the current study is to assess outcomes following TaTME for rectal cancer.MethodThis is a retrospective analysis of a prospectively maintained database of consecutive patients who underwent TaTME for rectal cancer at a single institution. The study period was from 1 March 2012 to 31 July 2015.ResultsDuring the study period 50 patients underwent TaTME. The median tumour distance from the anal verge was 4.4 (3.0-5.5)cm. The rate of conversion from a planned minimally invasive approach was 2.2%. The median operative time was 267.0 (227.0-331.0)min. The median lymph node yield was 18.0 (12.0-23.8), the macroscopic quality assessment of the resected specimen was incomplete in 2% and the circumferential resection margin positivity rate was 4%. Intra-operative morbidity occurred in 6% and the 30day morbidity rate was 36%. The median length of stay was 4.5 (4.0-8.0)days. The median follow-up was 15.1 (7.0-23.2) months; two patients have developed a local recurrence and eight patients have developed distant recurrence.ConclusionThese data suggest that TaTME for rectal cancer is feasible with an acceptable pathological outcome and morbidity profile. Further data on functional and long-term survival outcomes are required.