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Rasulov A.O.

Department of colorectal cancer

Jumabaev Kh.E.

Department of colorectal cancer

Kozlov N.A.

Department of Proctology and Department of Pathomorphology of N.N. Blokhin Russian Research Oncology Center, Moscow, Russia

Suraeva Yu.E.

Blokhin National Medical Cancer Research Center of Healthcare Ministry of Russia, Moscow, Russia

Mamedli Z.Z.

Department of colorectal cancer

Kulushev V.M.

Department of colorectal cancer

Gordeev S.S.

Blokhin National Medical Cancer Research Center of Healthcare Ministry of Russia, Moscow, Russia

Kuzmichev D.V.

Department of colorectal cancer

Polynovsky A.V.

Blokhin Russian Cancer Research Center, Ministry of Health of the Russian Federation, Moscow

Transanal mesorectumectomy for rectal cancer — is it optimal surgery for «difficult» patients?

Authors:

Rasulov A.O., Jumabaev Kh.E., Kozlov N.A., Suraeva Yu.E., Mamedli Z.Z., Kulushev V.M., Gordeev S.S., Kuzmichev D.V., Polynovsky A.V.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2018;(6): 4‑21

DOI: 10.17116/hirurgia201864-21

Read: 1430 times

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Table of contents

TRANSANAL MESORECTUMECTOMY FOR RECTAL CANCER — IS IT OPTIMAL SURGERY FOR «DIFFICULT» PATIENTS?
TRANSANAL MESORECTUMECTOMY FOR RECTAL CANCER — IS IT OPTIMAL SURGERY FOR «DIFFICULT» PATIENTS?

To cite this article:

Rasulov AO, Jumabaev KhE, Kozlov NA, et al. . Transanal mesorectumectomy for rectal cancer — is it optimal surgery for «difficult» patients? Pirogov Russian Journal of Surgery. 2018;(6):4‑21. (In Russ.)
https://doi.org/10.17116/hirurgia201864-21

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)
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Abstract:

Aim. To compare short-term outcomes after transanal total mesorectumectomy (Ta-TME) and laparoscopic (Lap-TME) procedure in «difficult» patients. Material and methods. Prospective nonrandomized trial included patients with confirmed middle-/low rectum adenocarcinoma T1-4aN0-2M0 for the period November 2013 — September 2016. We identified 20 out of 55 in TA-TME and 14 out of 54 patients in Lap-TME group as those of «difficult» subgroup: male, BMI ≥25 кг/м2, previous chemoradiotherapy (CRT). Results. Time of surgery, blood loss, conversions rate, postoperative morbidity and length of hospital-stay were similar in both groups. Hardware anastomoses were more frequent in TA-TME compared with LAP-TME group (78.9% vs. 50%, p=0.086). Specimen quality was more favorable in TA-TME group: Grade I 10% in Ta-TME group vs. 28.6% in Lap-TME group; «positive» CRM 5% vs. 14.3%, р=0.365. Within-group analysis did not reveal any differences between «difficult» and «typical» patients by surgical and pathomorphological characteristics in TA-TME group in contrast to Lap-TME group. Median of follow-up was 24.6 (IR 10.6—40.2) and 23.8 (IR 12.1—39.9) months for TA-TME and Lap-TME groups, respectively. Local recurrence occurred in 1 (1.8%) «difficult» patient after Ta-TME. Distant metastases were observed in 1 (1.8%) patient of Ta-TME and 2 (3.7%) patients of Lap-TME group. Actuarial 3-years reccurence-free survival was 95.7% for Ta-TME and 93.9% for Lap-TME group, respectively (p=0.923). Conclusion. TA-TME is advisable for “difficult” patients. Further multicenter randomized trials are necessary to specify the effectiveness of TA-TME in these patients.

Keywords:

rectal cancer
transanal mesorectumectomy
laparoscopic surgery
«difficult» patient

Authors:

Rasulov A.O.

Department of colorectal cancer

Jumabaev Kh.E.

Department of colorectal cancer

Kozlov N.A.

Department of Proctology and Department of Pathomorphology of N.N. Blokhin Russian Research Oncology Center, Moscow, Russia

Suraeva Yu.E.

Blokhin National Medical Cancer Research Center of Healthcare Ministry of Russia, Moscow, Russia

Mamedli Z.Z.

Department of colorectal cancer

Kulushev V.M.

Department of colorectal cancer

Gordeev S.S.

Blokhin National Medical Cancer Research Center of Healthcare Ministry of Russia, Moscow, Russia

Kuzmichev D.V.

Department of colorectal cancer

Polynovsky A.V.

Blokhin Russian Cancer Research Center, Ministry of Health of the Russian Federation, Moscow

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