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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
ECHEVERRI-GOMEZ, Claudia Marcela et al. Trans anal total meso-rectal excision (TaTME). Institutional experience. rev. colomb. cir. [online]. 2023, vol.38, n.2, pp.275-282. Epub Jan 23, 2023. ISSN 2011-7582. https://doi.org/10.30944/20117582.2232.
Introduction.
Surgery is the pillar of curative treatment for rectal cancer. Total meso-rectal excision has improved oncological outcomes, decreasing locoregional recurrence rates and impacting overall survival. The use of this technique in tumors of the middle or distal rectum is a surgical challenge, in which the trans anal route allows overcoming technical difficulties.
Method.
A retrospective observational study was carried out, collecting information from patients with middle and distal rectal cancer undergoing surgery with this technique, in two level 4 institutions in Medellín, Colombia, between January 2017 and March 2022.
Results.
Twenty-eight patients were included; their demographic characteristics, perioperative morbidity, and surgical specimen were analyzed. All patients underwent the trans anal and laparoscopic procedures simultaneously; 57% underwent a protective ileostomy. There was no perioperative mortality. Complications occurred in 60.7% of the patients. Only four cases of anastomotic leak occurred.
Conclusions.
The perioperative morbidity rate is consistent with that reported in the literature; the importance of the surgical curve and to include the qualification of the meso-rectal integrity within the pathological report is highlighted. Long-term follow-up is required to determine the impact on oncological outcomes, quality of life, and morbidity.
Keywords : neoplasms of the rectum; adenocarcinoma; laparoscopy; colorectal surgery; intraoperative complications.