Detalles técnicos en el TaTME laparoscópico para el cáncer de recto medio-bajo
- P. Tejedor 1
- M. Ortega-López 1
- M. León-Arellano 1
- H. Guadalajara 1
- D. García-Olmo 1
- C. Pastor 1
- 1 Departamento de Cirugía. Unidad de Cirugía Colorrectal. Hospital Universitario Fundación Jiménez Díaz. Madrid.
ISSN: 2695-3811, 1130-3212
Año de publicación: 2018
Volumen: 29
Número: 4
Páginas: 552-554
Tipo: Artículo
Otras publicaciones en: Cirugía Andaluza
Resumen
Transanal total mesorectal excision (TaTME) is a novel technique for rectal resections that combines abdominal and transanal approaches. It is especially useful in very low rectal tumours located in a narrow pelvis, in which a laparoscopic approach is technically challenging. There are several advantages for this procedure compared to laparoscopy such as higher rates of free circumferential and distal margins and a better quality of the specimen in the technique of total mesorectal excision (TME). However, the drawbacks are: the need of two laparoscopic sets, the complexity of the technique and the learning curve, which even exists for experienced surgeons in minimally invasive surgery. We aimed to analyze some technical details to make an appropriate dissection when performing TaTME. Both the abdominal and transanal approach were analyzed, including the type of the anastomosis and some technical modifications needed regarding the type of tumor faced in the Rullier classification. In our experience, TaTME is a safe option for low rectal cancer treatment, requiring TME, especially in males and patients with a narrow pelvis. It is a novel and complex surgery, with a long learning curve; however, the acquired experience performing TaTME and the evolution of the transanal devices make it feasible and reproducible. The standardization of the surgical technique may improve the short-term outcomes.
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