Skip to main content
SpringerLink
Log in

New Surgical Modalities in the Management of Rectal Cancer

  • Chapter
  • First Online:
GI Surgery Annual

Part of the book series: GI Surgery Annual ((GISA,volume 25))

  • 353 Accesses

Abstract

Colorectal cancer is the third most commonly diagnosed cancer worldwide. It accounts for over 8% of all cancer deaths, making it the fourth most common cause of cancer-related deaths. Professor Bill Heald was the first to describe the technique of total mesorectal excision (TME) in 1982. His landmark publication in 1986, revolutionized surgery for rectal cancer and TME, became the gold standard surgical technique for rectal cancer [1]. A complete total mesorectal excision, with intact mesorectal fascia and no invasion into the muscular coat, is the desired endpoint of any oncological procedure for carcinoma rectum. It is associated with decreased local recurrence and improved cancer-specific survival which is an important positive prognostic factor against local tumour recurrence and also for cancer-specific survival [2–4]. This era of TME has evolved from the traditional “open” approach to minimal access surgeries, such as laparoscopy, robotics and more recently the transanal approach.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Heald RJ, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986;1:1479–82.

    Article  CAS  Google Scholar 

  2. Kapiteijn E, Marijnen CA, Colenbrander AC, et al. Local recurrence in patients with rectal cancer diagnosed between 1988 and 1992: a population-based study in the west Netherlands. Eur J Surg Oncol. 1998;24:528–35.

    Article  CAS  Google Scholar 

  3. Quirke P, Durdey P, Dixon MF, Williams NS. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection: histopathological study of lateral tumour spread and surgical excision. Lancet. 1986;2:996–9.

    Article  CAS  Google Scholar 

  4. Quirke P, Steele R, Monson J, et al. Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet. 2009;373:821–8.

    Article  Google Scholar 

  5. Sylla P, Rattner DW, Delgado S, Lacy AM. NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc. 2010;24:1205–10. https://doi.org/10.1007/s00464-010-0965-6.

    Article  PubMed  Google Scholar 

  6. Lacy AM, Tasende MM, Delgado S, Fernandez-Hevia M, Jimenez M, De Lacy B, Castells A, Bravo R, Wexner SD, Heald RJ. Transanal total mesorectal excision for rectal cancer: outcomes after 140 patients. J Am Coll Surg. 2015;221:415–23. https://doi.org/10.1016/j.jamcollsurg.2015.03.046.

    Article  PubMed  Google Scholar 

  7. Marks JH, Myers EA, Zeger EL, Denittis AS, Gummadi M, Marks GJ. Long-term outcomes by a transanal approach to total mesorectal excision for rectal cancer. Surg Endosc. 2017;31:5248–57.

    Article  Google Scholar 

  8. Ito M, Sugito M, Kobayashi A, et al. Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resection. Int J Color Dis. 2008;23(7):703–7.

    Article  Google Scholar 

  9. van der Pas MHGM, Haglind E, Cuesta MA, Furst A, Lacy AM, Hop WCJ, Bonjer HJ. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013;14:210–8. 3.

    Article  Google Scholar 

  10. Buess G, Theiss R, Günther M, Hutterer F, Pichlmaier H. Endoscopic surgery in the rectum. Endoscopy. 1985;17:31–5. 7.

    Article  CAS  Google Scholar 

  11. Atallah S, Albert M, Larach S. Transanal minimally invasive surgery: a giant leap Kalloo AN, Singh VK, Jagannath SB, Niiyama H, Hill SL, Vaughn CA, Magee CA. Surg Endosc. 2010;24:2200–5. 8.

    Article  Google Scholar 

  12. Kantsevoy S. Flexible transgastricperitoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc. 2004;60:114–7.

    Article  Google Scholar 

  13. Rieder E, Spaun GO, Khajanchee YS, et al. A natural orifice transrectal approach for oncologic resection of the rectosigmoid: an experimental study and comparison with conventional laparoscopy. Surg Endosc. 2011;25:3357–63.

    Article  Google Scholar 

  14. Mizrahi I, Sands D. Total mesorectal excision for rectal cancer: a review. Ann Laparosc Endosc Surg. 2017;2:144.

    Article  Google Scholar 

  15. de Lacy FB, Chadi SA, Berho M, Heald RJ, Khan J, Moran B, et al. The future of rectal cancer surgery: a narrative review of an International Symposium. Surg Innov. 2018;25(5):525–35. https://doi.org/10.1177/1553350618781227.

    Article  PubMed  Google Scholar 

  16. Motson RW, Whiteford MH, Hompes R, Albert M, Miles WFA, The Expert Group. Current status of trans-anal total mesorectal excision (TaTME) following the Second International Consensus Conference. Color Dis. 2016;18(1):13–8.

    Article  CAS  Google Scholar 

  17. Leroy J, Barry BD, Melani A, Mutter D, Marescaux J. Noscartransanal total mesorectal excision: the last step to pure NOTES for colorectal surgery. JAMA Surg. 2013;148:226–30.

    Article  Google Scholar 

  18. Fernandez-Hevia M, Delgado S, Castells A, et al. Transanal total mesorectal excision in rectal cancer: short-term outcomes in comparison with laparoscopic surgery. Ann Surg. 2015;261:221–7.

    Article  Google Scholar 

  19. Emhoff IA, Lee GC, Sylla P. Transanal colorectal resection using natural orifice translumenal endoscopic surgery (NOTES). Dig Endosc. 2014;26(Suppl 1):29–42.

    Article  Google Scholar 

  20. Arroyave MC, DeLacy FB, Lacy AM. Transanal total mesorectal excision (TaTME) for rectal cancer: step by step description of the surgical technique for a two-teams approach. Eur J Surg Oncol. 2017;43:502–5. https://doi.org/10.1016/j.ejso.2016.10.024.

    Article  CAS  PubMed  Google Scholar 

  21. Atallah S. Transanal total mesorectal excision: full steam ahead. Tech Coloproctol. 2015;19:57–61. https://doi.org/10.1007/s10151-014-1254-5.

    Article  CAS  PubMed  Google Scholar 

  22. Heald RJ. A new solution to some old problems: transanal TME. Tech Coloproctol. 2013;17:257–8. https://doi.org/10.1007/s10151-013-0984-0.

    Article  CAS  PubMed  Google Scholar 

  23. Denost Q, Adam JP, Rullier A, Buscail E, Laurent C, Rullier E. Perineal transanal approach: a new standard for laparoscopic sphincter-saving resection in low rectal cancer, a randomized trial. Ann Surg. 2014;260:993–9.

    Article  Google Scholar 

  24. Penna M, Hompes R, Arnold S, Wynn G, Austin R, Warusavitarne J, Moran B, Hanna GB, Mortensen NJ, Tekkis PP, TaTME Registry Collaborative. Transanal total mesorectal excision: international registry results of the first 720 cases. Ann Surg. 2017;266:111–7.

    Article  Google Scholar 

  25. Francis N, Penna M, Mackenzie H, Carter F, Hompes R, International TaTME Educational Collaborative Group. Consensus on structured training curriculum for transanal total mesorectal excision (TaTME). Surg Endosc. 2017;31:2711–9.

    Article  Google Scholar 

  26. Xu W, Xu Z, Cheng H, Ying J, Cheng F, Xu W, Cao J, Luo J. Comparison of short-term clinical outcomes between transanal and laparoscopic total mesorectal excision for the treatment of mid and low rectal cancer: a meta-analysis. Eur J Surg Oncol. 2016;42:1841–50.

    Article  CAS  Google Scholar 

  27. Ma B, Gao P, Song Y, Zhang C, Zhang C, Wang L, Liu H, Wang Z. Transanal total mesorectal excision (taTME) for rectal cancer: a systematic review and meta-analysis of oncological and perioperative outcomes compared with laparoscopic total mesorectal excision. BMC Cancer. 2016;16:380.

    Article  Google Scholar 

  28. Dumont F, Ayadi M, Goéré D, Honoré C, Elias D. Comparison of fecal continence and quality of life between intersphincteric resection and abdominoperineal resection plus perineal colostomy for ultra-low rectal cancer. J Surg Oncol. 2013;108:225–9. https://doi.org/10.1002/jso.23379.

    Article  CAS  PubMed  Google Scholar 

  29. Rouanet P, Saint-Aubert B, Lemanski C, Senesse P, Gourgou S, Quenet F, Ycholu M, Kramar A, Dubois J. Restorative and nonrestorative surgery for low rectal cancer after high-dose radiation: long-term oncologic and functional results. Dis Colon Rectum. 2002;45:305–13; discussion 313–5.

    Article  Google Scholar 

  30. Koedam TW, van Ramshorst GH, Deijen CL, Elfrink AK, Meijerink WJ, Bonjer HJ, Sietses C, Tuynman JB. Transanal total mesorectal excision (TaTME) for rectal cancer: effects on patientreported quality of life and functional outcome. Tech Coloproctol. 2017;21:25–33. https://doi.org/10.1007/s10151-016-1570-z.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Atallah SB, DuBose AC, Burke JP, Nassif G, deBeche-Adams T, Frering T, Albert MR, Monson JRT. Uptake of transanal total mesorectal excision in north america: initial assessment of a structured training program and the experience of delegate surgeons. Dis Colon Rectum. 2017;60:1023–31. https://doi.org/10.1097/DCR.0000000000000823.

    Article  PubMed  Google Scholar 

  32. Velthuis S, VeltcampHelbach M, Tuynman JB, Le TN, Bonjer HJ, Sietses C. Intra-abdominal bacterial contamination in TAMIS total mesorectal excision for rectal carcinoma: a prospective study. Surg Endosc. 2015;29:3319–23. https://doi.org/10.1007/s00464-015-4089-x.

    Article  PubMed  Google Scholar 

  33. Buchs NC, Nicholson GA, Ris F, Mortensen NJ, Hompes R. Transanal total mesorectal excision: a valid option for rectal cancer? World J Gastroenterol. 2015;21:11700–8. https://doi.org/10.3748/wjg.v21.i41.11700.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Roy S, Evans C. Overview of robotic colorectal surgery: current and future practical developments. World J Gastrointest Surg. 2016;8(2):143.

    Article  Google Scholar 

  35. Pai A, Melich G, Marecik SJ, Park JJ, Prasad LM. Robotic surgery for colon and rectal cancer: current status, recent advances, and future directions. Curr Colorectal Cancer Rep. 2017;13(1):37–44.

    Article  Google Scholar 

  36. Prete FP, Pezzolla A, Prete F, Testini M, Marzaioli R, Patriti A, et al. Robotic versus laparoscopic minimally invasive surgery for rectal cancer: a systematic review and meta-analysis of randomized controlled trials. Ann Surg. 2018;267(6):1034–46.

    Article  Google Scholar 

  37. Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, et al. Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA. 2017;318(16):1569.

    Article  Google Scholar 

  38. Xiong B, Ma L, Zhang C, Cheng Y. Robotic versus laparoscopic total mesorectal excision for rectal cancer: a meta-analysis. J Surg Res. 2014;188(2):404–14.

    Article  Google Scholar 

  39. Park EJ, Cho MS, Baek SJ, Hur H, Min BS, Baik SH, Lee KY, Kim NK. Long-term oncologic outcomes of robotic low anterior resection for rectal cancer: a comparative study with laparoscopic surgery. Ann Surg. 2015;261:129–37.

    Article  Google Scholar 

  40. Hara M, Sng K, Yoo BE, Shin JW, Lee DW, Kim SH. Robotic-assisted surgery for rectal adenocarcinoma: short-term and midterm outcomes from 200 consecutive cases at a single institution. Dis Colon Rectum. 2014;57(5):570–7.

    Article  Google Scholar 

  41. Atallah S, Nassif G, Polavarapu H, deBeche-Adams T, Ouyang J, Albert M, et al. Robotic-assisted transanal surgery for total mesorectal excision (RATS-TME): a description of a novel surgical approach with video demonstration. Tech Coloproctol. 2013;17(4):441–7.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of GI Surgery, GI Oncology and Minimal Access Surgery, Medanta-The Medicity, Gurgaon, India

    Deeksha Kapoor, Amanjeet Singh & Adarsh Chaudhary

Authors
  1. Deeksha Kapoor
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amanjeet Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Adarsh Chaudhary
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of GI Surgery and Liver Transplantation, All India Institute of Medical Sciences, New Delhi, India

    Peush Sahni

  2. Department of GI Surgery and Liver Transplantation, All India Institute of Medical Sciences, New Delhi, India

    Sujoy Pal

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Indian Association of Surgical Gastroenterology

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kapoor, D., Singh, A., Chaudhary, A. (2019). New Surgical Modalities in the Management of Rectal Cancer. In: Sahni, P., Pal, S. (eds) GI Surgery Annual. GI Surgery Annual, vol 25. Springer, Singapore. https://doi.org/10.1007/978-981-13-3227-2_4

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-3227-2_4

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-3226-5

  • Online ISBN: 978-981-13-3227-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation