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Results of transanal mesorectumectomy in patients with rectal cancer

https://doi.org/10.17650/2220-3478-2017-7-1-11-17

Abstract

Objective: comparative analysis of specific perioperative features and pathological characteristics of the removed sample after laparoscopic total mesorectumectomy (Lap-TME) and transanal total mesorectumectomy (Ta-TME).
Materials and methods. A prospective non-randomized controlled study was carried out from November 2013 until September 2016. Patients with сТ1–4aN0–2M0 cancer of low- or medium-ampullar section of rectum were enrolled.
Results. 55 and 54 patients were included in the Ta-TME and Lap-TME groups respectively. Duration of surgery was 285 min (Ta-TME group) and 260 min (Lap-TME group); median volume of blood loss was less than 100 ml; duration of hospital stay after surgery was 7 days in both groups. 1 (1.8 %) patient from Ta-TME group and 3 (5.6 %) patients from the control group had conversion to open surgery (р = 0.223). Transanal removal of the sample was done in 53.7 % of the cases in Ta-TME group and 25.5 % of the cases in Lap-TME group (p = 0.008). Complications were registered in 27,3 and 24,1 % of the patients respectively (р = 0,436). 90.9 % of the patients from Ta-TME group had Grade 2–3 quality of mesorectumectomy, while in Lap-TME group this parameter was 85.2 % (p = 0.266). Circumferential resection margin damage was observed in 7.3 % of cases from Ta-TME group and 9.3 % of cases from Lap-TME group (p = 0.488).
Conclusion. Ta-TME does not worsen short-term oncological results. Further randomized studies are required to identify those patients who would benefit from bottoms up mesorectumectomy.

About the Authors

A. O. Rasulov
N. N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


Kh. E. Dzhumаbaev
N. N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


V. M. Kulushev
N. N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


Z. Z. Mamedli
N. N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


N. A. Kozlov
N. N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


S. S. Gordeev
N. N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


A. B. Baychorov
N. N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478, Russia


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