Users Online : 873 About us |  Subscribe |  e-Alerts  | Feedback | Login   
Journal of Minimal Access Surgery Current Issue | Archives | Ahead Of Print Journal of Minimal Access Surgery
           Print this page Email this page   Small font sizeDefault font sizeIncrease font size 
 ¤   Next article
 ¤   Previous article
 ¤   Table of Contents

 ¤   Similar in PUBMED
 ¤  Search Pubmed for
 ¤  Search in Google Scholar for
 ¤Related articles
 ¤   Citation Manager
 ¤   Access Statistics
 ¤   Reader Comments
 ¤   Email Alert *
 ¤   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed3215    
    Printed129    
    Emailed6    
    PDF Downloaded156    
    Comments [Add]    
    Cited by others 1    

Recommend this journal

 

 ORIGINAL ARTICLE
Year : 2014  |  Volume : 10  |  Issue : 3  |  Page : 144-150

"Down-to-Up" transanal NOTES Total mesorectal excision for rectal cancer: Preliminary series of 9 patients


1 Innovative Surgery Division, Klinikum Bremerhaven Reinkenheide, Germany; Department of Surgery, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil
2 Department of Surgery, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil
3 ICENI Centre, Colchester, United Kingdom
4 Gastrobeso Center, Sao Paulo-Brazil

Correspondence Address:
Ricardo Zorron
Director, Innovative Surgery Division, Klinikum Bremerhaven Reinkenheide, Germany, NOTES Research Group Brasil, Postbrookstrasse 66, 27574 Bremerhaven, Germany

Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9941.134878

Rights and Permissions

Background: Applications for natural orifice translumenal endoscopic surgery (NOTES) to access the abdominal cavity have increased in recent years. Despite potential advantages of transanal and transcolonic NOTES for colorectal pathology, it has not been widely applied in the clinical setting. This study describes a series of nine patients for whom we performed transanal retrograde ("Down-to-Up") total mesorectal excision for rectal cancer. Materials And Methods: Under IRB approval, informed consent was obtained from each patient with rectal adenocarcinoma. Rectosigmoidectomy with total mesorectal excision was performed using low rectal translumenal access to the mesorectal fascia and subsequent dissection in a retrograde fashion. This was achieved using either a single port device or flexible colonoscope with endoscopic instrumentation and laparoscopic assistance. This was followed by transanal extraction of the specimen and hand-sewn anastomosis. Results: Mean operative time was 311 min. Mean hospital stay was 7.56 days. Complications occurred in two patients, and consisted of one anastomotic leakage with reoperation and one intraoperative conversion to open surgery because of impossibility to dissect the specimen. TME specimen integrity was adequate in six patients. Conclusion: This series suggests that a retrograde mesorectal dissection via a NOTES technique is feasible in patients with rectal adenocarcinoma. This technique may act as a complimentary part of operative treatment for rectal cancer alongside other minimally invasive strategies. Long-term follow up will be needed to assess oncological results.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

© 2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04