Transanal Total Mesorectal Excision (TaTME): Experience in Klaipėda University Hospital
Original research work
Vita Klimašauskienė
Vilnius University, Lithuania
Narimantas Evaldas Samalavičius
Vilnius University, Lithuania
Published 2019-12-20
https://doi.org/10.15388/LietChirur.2019.18.15
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Keywords

rectal cancer
transanal total mesorectal excision
TaTME

How to Cite

1.
KlimašauskienėV, Samalavičius NE. Transanal Total Mesorectal Excision (TaTME): Experience in Klaipėda University Hospital. LS [Internet]. 2019Dec.20 [cited 2020Aug.8];18(4):235-8. Available from: https://www.journals.vu.lt/lietuvos-chirurgija/article/view/16298

Abstract

Introduction. Colorectal cancer ranks third on the list of the most common cancers. In 1979 R. J. Heald described total mesorectam excision (TME) which became a gold standard for rectal cancer treatment. This operation is performed all over the world open, laparoscopic and robotic. Operating on low and very low rectal cancer, distal bowel mobilisation if often the most difficult part of the operation. Aa a solution to this problem transanal abdominotransanal rectal resection (TATA) and transanal total mesorectal excision (TaTME) were proposed. This article reviews the experience and short-term postoperative outcomes of TaTME performed in Klaipėda University Hospital.
Methods. The first stage of surgery was performed with patient placed in the prone jackknife (Kraske) position. Using electrocauthery circular mobilisation of the rectum was performed starting at least 1 cm from the lower edge of the tumour. Up to 10 cm of the rectum was mobilised from below. The second stage was performed with patient in lithotomy position. Laparoscopic TME was performed. For 11 (78.57%) patients hand sown anastomosis was performed and for 1 (7.17%) patient stapler was used. 2 (14.28%) patients underwent the Hartmann’s procedure.
Results. In period 2018.03–2019.10 TaTME was performed for 14 patients. The medium tumour high counting from dentate line was 2.54 (±1.28). 13 out of 14 patients were operated from 8 to 12 weeks after chemoradiotherapy. All (100%) rectal resections were radical (R0). On average 11.43 (±3.78) lymphnodes were harvested. 5 (35.71%) patients had complications after surgery.
Conclusions. TaTME performed at Klaipėda University Hospital is effective operation for rectal cancer treatment.

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