Advertisement

New Surgical Modalities in the Management of Rectal Cancer

  • Deeksha Kapoor
  • Amanjeet Singh
  • Adarsh Chaudhary
Chapter
Part of the GI Surgery Annual book series (GISA, volume 25)

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.

References

  1. 1.
    Heald RJ, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986;1:1479–82.CrossRefGoogle Scholar
  2. 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.CrossRefGoogle Scholar
  3. 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.CrossRefGoogle Scholar
  4. 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.CrossRefGoogle Scholar
  5. 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.CrossRefPubMedGoogle Scholar
  6. 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.CrossRefPubMedGoogle Scholar
  7. 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.CrossRefGoogle Scholar
  8. 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.CrossRefGoogle Scholar
  9. 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.CrossRefGoogle Scholar
  10. 10.
    Buess G, Theiss R, Günther M, Hutterer F, Pichlmaier H. Endoscopic surgery in the rectum. Endoscopy. 1985;17:31–5. 7.CrossRefGoogle Scholar
  11. 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.CrossRefGoogle Scholar
  12. 12.
    Kantsevoy S. Flexible transgastricperitoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc. 2004;60:114–7.CrossRefGoogle Scholar
  13. 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.CrossRefGoogle Scholar
  14. 14.
    Mizrahi I, Sands D. Total mesorectal excision for rectal cancer: a review. Ann Laparosc Endosc Surg. 2017;2:144.CrossRefGoogle Scholar
  15. 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.CrossRefPubMedGoogle Scholar
  16. 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.CrossRefGoogle Scholar
  17. 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.CrossRefGoogle Scholar
  18. 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.CrossRefGoogle Scholar
  19. 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.CrossRefGoogle Scholar
  20. 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.CrossRefPubMedGoogle Scholar
  21. 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.CrossRefPubMedGoogle Scholar
  22. 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.CrossRefPubMedGoogle Scholar
  23. 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.CrossRefGoogle Scholar
  24. 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.CrossRefGoogle Scholar
  25. 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.CrossRefGoogle Scholar
  26. 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.CrossRefGoogle Scholar
  27. 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.CrossRefGoogle Scholar
  28. 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.CrossRefPubMedGoogle Scholar
  29. 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.CrossRefGoogle Scholar
  30. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 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.CrossRefPubMedGoogle Scholar
  32. 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.CrossRefPubMedGoogle Scholar
  33. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Roy S, Evans C. Overview of robotic colorectal surgery: current and future practical developments. World J Gastrointest Surg. 2016;8(2):143.CrossRefGoogle Scholar
  35. 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.CrossRefGoogle Scholar
  36. 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.CrossRefGoogle Scholar
  37. 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.CrossRefGoogle Scholar
  38. 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.CrossRefGoogle Scholar
  39. 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.CrossRefGoogle Scholar
  40. 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.CrossRefGoogle Scholar
  41. 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.CrossRefGoogle Scholar

Copyright information

© Indian Association of Surgical Gastroenterology 2019

Authors and Affiliations

  • Deeksha Kapoor
    • 1
  • Amanjeet Singh
    • 1
  • Adarsh Chaudhary
    • 1
  1. 1.Department of GI Surgery, GI Oncology and Minimal Access SurgeryMedanta-The MedicityGurgaonIndia

Personalised recommendations