No-Scar Transanal Total Mesorectal Excision

Leroy, Joël; Barry, Brian; Melani, Armando Geraldo Franchini; Mutter, Didier; Marescaux, Jacques

doi:10.1001/jamasurg.2013.685

Cited by 136 publications

(20 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…123,124 Pure NOTES transanal TME Leroy et al described one of the only two cases of pure NOTES transanal TME done for a preoperatively staged T2 rectal cancer, with final pathology demonstrating a tubulovillous adenoma. 125 Bottom-up mesorectal excision was completed using a rigid metal TES platform, and coloanal handsewn anastomosis was done with no diverting ileostomy. The patient developed a small pelvic hematoma requiring CT-guided drainage.…”

Section: Functional Outcomesmentioning

confidence: 99%

Transanal colorectal resection using natural orifice translumenal endoscopic surgery (NOTES)

Emhoff

Lee

Sylla

2013

Digestive Endoscopy

View full text Add to dashboard Cite

The surgical management of rectal cancer has evolved over the past century, with total mesorectal excision (TME) emerging as standard of care. As a result of the morbidity associated with open TME, minimally invasive techniques have become popular. Natural orifice translumenal endoscopic surgery (NOTES) has been held as the next revolution in surgical techniques, offering the possibility of 'incisionless' TME. Early clinical series of transanal TME with laparoscopic assistance (n = 72) are promising, with overall intraoperative and postoperative complication rates of 8.3% and 27.8%, respectively, similar to laparoscopic TME. The mesorectal specimen was intact in all patients, and 94.4% had negative margins. There was no oncological recurrence in average-risk patients at short-term follow up, and 2-year survival rates in high-risk patients were comparable to that after laparoscopic TME. These preliminary studies demonstrate transanal NOTES TME with laparoscopic assistance to be clinically feasible and safe given careful patient selection, surgical expertise, and appropriate procedural training. We are hopeful that with optimization of transanal instruments and surgical techniques, pure transanal NOTES TME will become a viable alternative to open and laparoscopic TME in the future.

show abstract

Section: Functional Outcomesmentioning

confidence: 99%

Transanal colorectal resection using natural orifice translumenal endoscopic surgery (NOTES)

Emhoff

Lee

Sylla

2013

Digestive Endoscopy

View full text Add to dashboard Cite

show abstract

“…Most publications on NOTES have concentrated on short‐term outcomes11, 12, 13, 14. Among studies of colorectal cancer treated with hybrid NOTES, no local recurrence has been reported at 6 months6 24, 25 or 9 months11.…”

Section: Discussionmentioning

confidence: 99%

“…Since the first transgastric liver biopsy by Kalloo and colleagues1, there has been continued interest in natural orifice transluminal endoscopic surgery (NOTES)2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14. For colorectal cancer, most operations have been hybrid procedures4, 5, 6, 7, 8, 9, 10 with few reports11, 12, 13, 14 confined to NOTES alone.…”

Section: Introductionmentioning

confidence: 99%

“…For colorectal cancer, most operations have been hybrid procedures4, 5, 6, 7, 8, 9, 10 with few reports11, 12, 13, 14 confined to NOTES alone. In colorectal cancer surgery, potential benefits of NOTES might include less pain, avoidance of incisional infection, shorter hospital stay, better cosmesis and high‐quality oncological resection by transanal total mesorectal excision (TME)4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Natural orifice transluminal endoscopic surgery for colorectal cancer

Thien

Thanh

et al. 2017

BJS Open

View full text Add to dashboard Cite

BackgroundNatural orifice transluminal endoscopic surgery (NOTES) has theoretical advantages over other approaches.MethodsThis was a prospective cohort study of colorectal cancers operated on by NOTES (transanally for rectal tumours, transvaginally for sigmoid tumours) between December 2013 and December 2015, with a minimum follow‐up of 1 year. Eligibility criteria included ASA fitness grade I–III, BMI below 25 kg/m2 and TNM stage T3 N0 M0. Exclusion criteria included pregnancy or distant metastasis. The anastomosis was either handsewn or performed mechanically.ResultsSixteen patients were operated on by a transanal and four by a transvaginal approach. There were ten men and ten women, with a mean(s.d.) age of 55·6(12·1) years. Mean BMI was 22·4(2·6) kg/m2. Four anterior, 11 low anterior and five intersphincteric resections were performed for 16 rectal and four low sigmoid tumours. The mean duration of surgery was 258(11) min. No conversion to laparotomy was needed, and there were no deaths. Five patients required additional ports, for intraoperative bleeding (1), suture of an intraoperative urethral injury with covering ileostomy (1) and difficulty in dissection (3). One patient had an anastomotic leak requiring transanal closure and ileostomy on day 7. Both ileostomies were closed after 2 months. The mean hospital stay was 6·4(1·8) days. All resections were R0.ConclusionIn carefully selected patients NOTES for colorectal cancer resection was feasible and effective.

show abstract

“…Several authors have reported pure natural orifice transluminal endoscopic surgery (NOTES) [25,44,45] without an abdominal wound. Intraperitoneal maneuvers, such as high ligation of the inferior mesenteric artery, mobilization of the left colon, etc., are difficult because of the angulation of the promontrium or limitations in the length of the instrument.…”

Section: Future Perspectivementioning

confidence: 99%

Transanal total mesorectal excision for rectal cancer

et al. 2015

View full text Add to dashboard Cite

Although laparoscopic surgery for rectal cancer has been gaining acceptance with the gradual accumulation of evidence, it remains a technically demanding procedure in patients with a narrow pelvis, bulky tumors, or obesity. To overcome the technical difficulties associated with laparoscopic rectal dissection and transection, transanal endoscopic rectal dissection, which is also referred to as transanal (reverse, bottom-up) total mesorectal excision (TME), has recently been introduced. Its potential advantages include the facilitation of the dissection of the anorectum, regardless of the patient body habitus, and a clearly defined safe distal margin and transanal extraction of the specimen. This literature review shows that this approach seems to be feasible with regard to the operative and short-term postoperative outcomes. In experienced hands, transanal TME is a promising method for the resection of mid- and low-rectal cancers. Further investigations are required to clarify the long-term oncological and functional outcomes.

show abstract

No-Scar Transanal Total Mesorectal Excision

Cited by 136 publications

References 25 publications

Transanal colorectal resection using natural orifice translumenal endoscopic surgery (NOTES)

Transanal colorectal resection using natural orifice translumenal endoscopic surgery (NOTES)

Natural orifice transluminal endoscopic surgery for colorectal cancer

Transanal total mesorectal excision for rectal cancer

Contact Info

Product

Resources

About