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Techniques in Coloproctology

, Volume 23, Issue 8, pp 787–788 | Cite as

Delayed presentation of rectourethral fistula following TaTME (transanal total mesorectal excision)

  • F. TirelliEmail author
  • M. Grieco
  • A. Biondi
  • F. Belia
  • R. Persiani
Correspondence

Dear Sir

Performing transanal total mesorectal excision (TaTME) is, initially, challenging for almost every surgeon, even experienced colorectal surgeons. Some authors suggest a minimum of 30–40 cases to complete the learning curve and become confident with the surgical technique, for surgeons who are already well trained in minimally invasive surgery [1].

Moreover, major complications have been reported following TaTME [2]. We describe a case of urethral injury with delayed presentation following TaTME in an 87-year-old male (body mass index 30.12 kg/m2) with a past medical history significant for hypertension, hypercholesterolemia, chronic obstructive pulmonary disease, and benign prostatic hypertrophy. He underwent a TaTME with diverting ileostomy due to a low rectal adenocarcinoma on December 2017.

The procedure was a standard TaTME with a difficult anterior plane related to an uncommon acute angle between the anal canal and a large hypertrophic prostate. The procedure ended with a...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

Supplementary material

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Supplementary material 2 (JPEG 1800 kb)

References

  1. 1.
    Koedam TWA, Veltcamp Helbach M, van de Ven PM et al (2018) Transanal total mesorectal excision for rectal cancer: evaluation of the learning curve. Tech Coloproctol 22(4):279–287CrossRefGoogle Scholar
  2. 2.
    Penna M, Hompes R, Arnold S et al (2018) Incidence and risk factors for anastomotic failure in 1594 patients treated by transanal total mesorectal excision: results from the international TaTME registry. Ann Surg, International TaTME Registry Collaborative.  https://doi.org/10.1097/SLA.0000000000002653 Google Scholar
  3. 3.
    Heald RJ (2013) A new solution to some old problems: transanal TME. Tech Coloproctol 17(3):257–258CrossRefGoogle Scholar
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    Westwood DA, Cuda TJ, Hamilton AER, Clark D, Stevenson ARL (2018) Transanal total mesorectal excision for rectal cancer: state of the art. Tech Coloproctol 22(9):649–655CrossRefGoogle Scholar
  5. 5.
    Atallah SB, DuBose AC, Burke JP, Nassif G, deBeche-Adams T, Frering T, Albert MR, Monson JRT (2017) Uptake of transanal total mesorectal excision in North America: initial assessment of structured training program and the experience of delegate surgeons. Dis Colon Rectum. 60(10):1023–1031CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.General Surgery DepartmentFondazione Policlinico Universitario A. Gemelli IRCCS, RomaRomeItaly
  2. 2.General Surgery DepartmentFondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro CuoreRomeItaly

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