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Colorectal cancer
Dissection layer selection based on an understanding of pelvic fascial anatomy in transanal total mesorectal excision
Daichi Kitaguchi, Masaaki Ito
Ann Coloproctol. 2024;40(4):375-383.   Published online August 30, 2024
DOI: https://doi.org/10.3393/ac.2024.00178.0025
  • 2,378 View
  • 82 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
This study aimed to review the historical transition of rectal cancer surgery and recent evidence regarding transanal total mesorectal excision (TaTME). Additionally, it outlined the anatomical landmarks and technical considerations essential for successful TaTME. Anatomical studies and surgical techniques were analyzed to identify key landmarks and procedural steps crucial for TaTME. TaTME offers improved visibility and maneuverability even in the deep and narrow pelvis and is expected to contribute to tumor radical cure rates. By securing the circumferential resection margin and distal margin while preserving pelvic autonomic nerve function, TaTME holds promise for maintaining postoperative urinary and sexual functions. Key anatomical landmarks include the endopelvic fascia posteriorly, the S4-pelvic splanchnic nerve laterally, and the prostate or posterior vaginal wall anteriorly. Selecting the appropriate dissection layer based on tumor depth and ensuring precise incision of the tendinous arch of the pelvic fascia contributes to successful TaTME outcomes. TaTME represents a significant advancement in rectal cancer surgery, offering improved outcomes through meticulous attention to anatomical detail and precise dissection techniques. Understanding the historical context of rectal cancer surgery alongside recent evidence on TaTME is essential for optimizing patient outcomes and expanding the safe implementation of this innovative approach.

Citations

Citations to this article as recorded by  
  • From the Editor: Uniting expertise, a new era of global collaboration in coloproctology
    In Ja Park
    Annals of Coloproctology.2024; 40(4): 285.     CrossRef
  • Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
    Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    Cancers.2024; 16(24): 4280.     CrossRef
Optimal anastomotic technique in rectal surgery to prevent anastomotic leakage
Daichi Kitaguchi, Masaaki Ito
Ann Coloproctol. 2023;39(2):97-105.   Published online January 3, 2023
DOI: https://doi.org/10.3393/ac.2022.00787.0112
  • 5,388 View
  • 419 Download
  • 10 Web of Science
  • 10 Citations
AbstractAbstract PDF
Complications after colorectal surgery remain inevitable, and anastomotic leakage is one of the most severe and potentially fatal complications. Generally, anastomotic leakage is associated with severe peritonitis, the need for emergency reoperation, and an increased mortality rate. Additionally, particularly after rectal cancer surgery, it has a negative impact on long-term outcomes, including postoperative anorectal function, local recurrence, and survival. To prevent anastomotic leakage, understanding the characteristics of each anastomotic technique and establishing a stable anastomotic procedure are important. Transanal total mesorectal excision (TaTME) is a relatively new advanced surgical access technique for pelvic dissection and facilitates different anastomotic techniques without the need for transabdominal rectal transection. Especially, stapled anastomosis in TaTME, also known as double purse-string circular stapled anastomosis or the single stapling technique (SST), has gained much attention as an alternative to the conventional double stapling technique (DST). In this article, we describe the DST, SST, and hand-sewn anastomosis as anastomotic techniques after rectal surgery, focusing mainly on the differences between conventional anastomotic techniques and SST in TaTME. Furthermore, the blood flow evaluation method for the reconstructive colon before anastomosis, which is extremely important in anastomotic leakage prevention regardless of the anastomotic type, is also described.

Citations

Citations to this article as recorded by  
  • Dissection layer selection based on an understanding of pelvic fascial anatomy in transanal total mesorectal excision
    Daichi Kitaguchi, Masaaki Ito
    Annals of Coloproctology.2024; 40(4): 375.     CrossRef
  • Successful Clinical Avoidance of Colorectal Anastomotic Leakage through Local Decontamination
    Gerhard Ernst Steyer, Markus Puchinger, Johann Pfeifer
    Antibiotics.2024; 13(1): 79.     CrossRef
  • Combined Robotic Transanal Transection Single-Stapled Technique in Ultralow Rectal Endometriosis Involvement Associated With Parametrial and Vaginal Infiltration
    Gianmarco D'Ancona, Benjamin Merlot, Quentin Denost, Stefano Angioni, Thomas Dennis, Horace Roman
    Journal of Minimally Invasive Gynecology.2024; 31(4): 267.     CrossRef
  • Risk factors for the failure of endoscopic balloon dilation to manage anastomotic stricture from colorectal surgery: retrospective cohort study
    Young Il Kim, Seung Wook Hong, Seok-Byung Lim, Dong-Hoon Yang, Eon Bin Kim, Min Hyun Kim, Chan Wook Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Chang Sik Yu
    Surgical Endoscopy.2024; 38(4): 1775.     CrossRef
  • The impact of powered circular staplers on anastomotic leak in left-sided colorectal cancer surgeries
    Hayoung Lee, Yong Sik Yoon, Young Il Kim, Eun Jung Park, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim
    Surgical Endoscopy.2024; 38(10): 6111.     CrossRef
  • Effect of powered circular stapler in colorectal anastomosis after left-sided colic resection: systematic review and meta-analysis
    Andrea Scardino, Carlo Galdino Riva, Luca Sorrentino, Sara Lauricella, Alberto Aiolfi, Matteo Rottoli, Gianluca Bonitta, Marco Vitellaro, Luigi Bonavina, Davide Bona, Michael Kelly, Emanuele Rausa
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
  • Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
    Gyung Mo Son
    Annals of Coloproctology.2024; 40(5): 415.     CrossRef
  • Optimal Indocyanine Green Dosage for Repetitive Angiography for Laparoscopic Colorectal Surgery
    Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek
    Medicina.2024; 60(12): 1966.     CrossRef
  • The Safe Values of Quantitative Perfusion Parameters of ICG Angiography Based on Tissue Oxygenation of Hyperspectral Imaging for Laparoscopic Colorectal Surgery: A Prospective Observational Study
    Gyung Son, Armaan Nazir, Mi Yun, In Lee, Sun Im, Jae Kwak, Sang-Ho Park, Kwang-Ryul Baek, Ines Gockel
    Biomedicines.2023; 11(7): 2029.     CrossRef
  • Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
    Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
    Cancers.2023; 15(20): 5098.     CrossRef
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