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Open Technique for Transanal Resection

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Surgery for Cancers of the Gastrointestinal Tract

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Abstract

Tumors in the lower third of the rectum present unique challenges for the surgeon. Local excision has long been a technique used as an alternative to radical surgery for these low rectal polyps and tumors. Radical resection in this location often requires a low rectal or colo-anal anastomosis or even an abdominoperineal excision, procedures that carry significant morbidity and mortality. For that reason, local excision has always been an appealing alternative with lower morbidity and preservation of function. However, improved functional outcomes have to be balanced with proper oncologic outcomes.

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References

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Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Vitaliy Poylin M.D.

  2. Harvard Medical School, Boston, MA, USA

    Vitaliy Poylin M.D.

  3. Division of Colon and Rectal Surgery, Department of Surgery, Tufts Medical Center, Tufts University School of Medicine, 800 Washington St, 6190, Boston, MA, 02111, USA

    James Yoo M.D.

Authors
  1. Vitaliy Poylin M.D.
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  2. James Yoo M.D.
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Corresponding author

Correspondence to James Yoo M.D. .

Editor information

Editors and Affiliations

  1. Division of Surgical Oncology, City of Hope, Los Angeles, California, USA

    Joseph Kim

  2. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    Julio Garcia-Aguilar

Key Operative Steps

Key Operative Steps

  1. 1.

    Bowel prep with Fleets enema.

  2. 2.

    Place patient in prone-jackknife position.

  3. 3.

    Perform perianal and pudendal nerve blocks.

  4. 4.

    Place retaining sutures, if necessary.

  5. 5.

    Insert retractor into anus. For deeper lesions, everting sutures may be used.

  6. 6.

    Mark 1-cm margins of resection around the tumor.

  7. 7.

    Perform full-thickness resection along the margins. Must visualize perirectal fat to confirm adequacy of resection.

  8. 8.

    Close the defect transversely using absorbable sutures.

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© 2015 Springer Science+Business Media New York

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Poylin, V., Yoo, J. (2015). Open Technique for Transanal Resection. In: Kim, J., Garcia-Aguilar, J. (eds) Surgery for Cancers of the Gastrointestinal Tract. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1893-5_26

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  • DOI: https://doi.org/10.1007/978-1-4939-1893-5_26

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1892-8

  • Online ISBN: 978-1-4939-1893-5

  • eBook Packages: MedicineMedicine (R0)

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