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Original Articles
Colorectal cancer
- Recurrence following transanal total mesorectal excision for rectal cancer: a monocentric retrospective series of technically difficult cases
- Jonathan Frigault, Geneviève Morin, Sébastien Drolet, Philippe Bouchard, Alexandre Bouchard, Thanh-Quan Philips Ngo, François Letarte
- Ann Coloproctol. 2023;39(4):332-341. Published online November 14, 2022
- DOI: https://doi.org/10.3393/ac.2022.00178.0025
- 3,472 View
- 68 Download
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Abstract
PDF - Purpose
Transanal total mesorectal excision (TaTME) has been proposed to overcome surgical difficulties encountered during rectal resection, especially for patients having high body mass index or low rectal cancer. The aim of this study was to evaluate oncologic outcomes following TaTME.
Methods
This retrospective study included all consecutive patients with rectal cancer who had a TaTME from 2013 to 2019. The main outcome was the incidence of locoregional recurrence by the end of the follow-up period.
Results
Among a total of 81 patients, 96.3% were male, and their mean age was 63±9 years. The mean body mass index was 30.3±5.7 kg/m2, and the median distance from tumor to anal verge was 5.0 cm (interquartile range [IQR], 4.0–6.0 cm). Most patients had a low anterior resection performed (n=80, 98.8%) with a diverting ileostomy (n=64, 79.0%). Distal and circumferential resection margins were positive in 2.5% and 6.2% of patients, respectively. Total mesorectal excision was complete or near complete in 95.1% of patients. A successful resection was achieved in 72 patients (88.9%). After a median follow-up of 27.5 months (IQR, 16.7–48.1 months), 4 patients (4.9%) experienced locoregional recurrence. Anastomotic leaks were observed in 21 patients (25.9%). At the end of the follow-up, 69 patients (85.2%) were stoma-free.
Conclusion
TaTME was associated with acceptable oncological outcomes, including low locoregional recurrence rates in selected patients with low rectal cancer. Although associated with a high incidence of postoperative morbidities, the use of TaTME enabled a high rate of successful sphincter-saving procedures in selected patients who posed a technical challenge.
- Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study of anastomotic complications
- Jonathan Frigault, Samuel Avoine, Sébastien Drolet, François Letarte, Alexandre Bouchard, Jean-Pierre Gagné, Claude Thibault, Roger C. Grégoire, Naomee Jutras Bouthillette, Maude Gosselin, Philippe Bouchard
- Ann Coloproctol. 2023;39(2):147-155. Published online March 29, 2022
- DOI: https://doi.org/10.3393/ac.2021.00983.0140
- 4,798 View
- 178 Download
- 12 Web of Science
- 11 Citations
-
Abstract
PDF
- Purpose
Laparoscopic right hemicolectomy (LRH) can be performed with an intracorporeal anastomosis (IA) or extracorporeal anastomosis (EA). It is not clear which technique is best. This study evaluated the impact of each anastomosis technique on perioperative safety and postoperative evolution.
Methods
We performed a retrospective study at a tertiary colorectal surgery center. All patients who had an elective LRH from 2015 to 2019 were analyzed according to the anastomosis technique used.
Results
In total, 285 patients were included in the study. IA was performed in 64 patients (22.5%). Mean operative time was longer in the patients with IA (IA, 160±31 minutes vs. EA, 138±42 minutes; P<0.001). No differences were observed in intraoperative complications, time to first bowel movement, length of stay, reoperation, or rehospitalization. Time to first flatus was longer in the patients with IA (P=0.049). At 30 days after surgery, there were no differences in the frequency of anastomotic leak (IA, 0% vs. EA, 2.3%; P=0.59), bleeding (IA, 3.1% vs. EA, 2.7%; P>0.99), or intraabdominal abscess (IA, 0% vs. EA, 0.5%; P>0.99). During follow-up, we noted more incisional hernias in patients with EA (IA, 1.6% vs. EA, 11.3%; P=0.01) and a trend toward more hernia in patients with EA in multivariate analysis (hazard ratio, 7.13; P=0.06). Anastomosis technique had no influence on recurrence.
Conclusion
For LRH, both IA and EA are safe, with a low incidence of complications when performed by experienced surgeons. IA may be associated with a lower incidence of incisional hernia. -
Citations
Citations to this article as recorded by
- Short-term outcomes for intracorporeal vs. extracorporeal anastomosis in laparoscopic right hemicolectomy for colonic cancer—a prospective cohort study (ICEA-study)
Emilie Schultz Hougaard, Benedicte Schelde-Olesen, Issam Al-Najami, Thomas Buchbjerg, Benjamin Schnack Brandt Rasmussen, Lasse Bugge, Thomas Kolbro, Sören Möller, Mark Bremholm Ellebæk
International Journal of Colorectal Disease.2025;[Epub] CrossRef - Intracorporeal stapled versus extracorporeal hand-sewn anastomosis in minimal-invasive right hemicolectomy with complete mesocolic excision – a retrospective single center analysis
Maximilian Brunner, Katja Bondartschuk, Axel Denz, Georg F. Weber, Robert Grützmann, Christian Krautz
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef - Comparison of Robot‐Assisted and Laparoscopic Right Hemicolectomy for Right‐Sided Colon Cancer: A Report on the Short‐Term Perioperative Outcomes Using Propensity Score Matching
Shunsuke Sakuraba, Mizuki Nishiko, Shingo Yamasaki, Kazumasa Nakamura, Kohei Koido, Takeshi Oshima, Hiroyuki Hazama, Kou Ohata, Hideyuki Kanemto
Asian Journal of Endoscopic Surgery.2025;[Epub] CrossRef - Elevating surgical standards: The role of intraperitoneal isoperistaltic side-to-side anastomosis in colon cancer surgery
Sung Uk Bae
World Journal of Gastrointestinal Oncology.2025;[Epub] CrossRef - Revisiting Robotic Right Hemicolectomy: A Critical Appraisal of Perioperative Outcomes and Emerging Complications
Javed Iqbal, Brijesh Sathian, Syed Muhammad Ali
Asian Journal of Endoscopic Surgery.2025;[Epub] CrossRef - Comparison of intracorporeal and extracorporeal anastomosis in laparoscopic right colectomy: an updated meta-analysis and trial sequential analysis
Konstantinos Perivoliotis, George Tzovaras, Konstantinos Tepetes, Ioannis Baloyiannis
Updates in Surgery.2024; 76(2): 375. CrossRef - Effectiveness and safety of self-pulling and latter transection reconstruction in totally laparoscopic right hemicolectomy
Fuyu Yang, Fan He, Chenglin Tang, Defei Chen, Junjie Xiong, Yu Zou, Saed Woraikat, Kun Qian, Hui Li
Frontiers in Oncology.2024;[Epub] CrossRef - Single-Center Experiences: A Comparison of Intracorporeal and Extracorporeal Anastomosis Outcomes in Right Hemicolectomy
Audrey Kim, Munyaradzi G Nyandoro, Linda Vu, Ruben Rajan, Abraham Jacob
Cureus.2024;[Epub] CrossRef - Comparing extracorporeal, semi-extracorporeal, and intracorporeal anastomosis in laparoscopic right hemicolectomy: introducing a bridging technique for colorectal surgeons
Hye Jung Cho, Jong Woo Kim, Woo Ram Kim
Annals of Surgical Treatment and Research.2024; 107(1): 42. CrossRef - Effect of Specimen Extraction Site on Postoperative Incisional Hernia after Minimally Invasive Right Colectomy
Josh A Johnson, Andrea Mesiti, Margo Herre, Cyrus Farzaneh, Ying Li, Wini Zambare, Joseph Carmichael, Alessio Pigazzi, Mehraneh D Jafari
Journal of the American College of Surgeons.2024; 239(2): 107. CrossRef - Extracorporeal versus intracorporeal anastomosis for right colon cancer surgery
Seong Kyu Baek
Journal of Minimally Invasive Surgery.2022; 25(3): 91. CrossRef
- Short-term outcomes for intracorporeal vs. extracorporeal anastomosis in laparoscopic right hemicolectomy for colonic cancer—a prospective cohort study (ICEA-study)
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