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Abstract
Objective: We would like to present the techniques and the evaluate early results, the feasibility,
oncologic outcome and functional outcome of laparoscopic rectal resection combined with transanal
total mesorectal excision.
Materials and methods: Prospective study at Hue Central Hospital. From December 2016 to June
2019, a laparoscopic rectal resection combined with transanal total mesorectal excision was performed in
24 patients with rectal cancer at the Department of Abdominal Emergencies and Pediatric Surgery, Hue
Central Hospital, Hue, Vietnam.
Results: The pre-operative tumor stage was T2-3N0-1M0. 10 patients under went long-course
and 14 patients under went short-course radiation before surgery. 9 patient with low rectal cancer, 15
patients medium rectal cancer. No patients required blood transfusion during or after the operation.
No conversion to open surgery. There was no post-operative mortality. Mean operative time was 205
minutes. 24 patients required ileostomy protected the anatomosis. Average hospital stay was 6,7 days.
The coloanal or colorectal anastomosis was performed by hand-sewn (20 cases) or by EEA staplers
(4 case). Complication after surgery: 1 case had twisting ileostomy, 1 case had fistular anatomosis
and 1 case had pelvic abcess. Using Kirwan classification of functional outcomes after surgery, 20
patients had good continence (Kirwan I) and 4 had poor continence (Kirwan II). We closed ileostomy
after surgery 1 month.
Conclusions: Laparoscopic rectal resection combined with transanal total mesorectal excision is a safe
procedure in selected patients with low and medium rectal cancer and may provide a good continence.
It seems to be the first transanal total mesorectal excision (TaTME) for human in Viet Nam. However, a
multicentric study in a large numbers of patient and a long follow-up is necessary.
Keywords: rectal cancer, laparoscopic rectal resection combined with transanal total mesorectal
excisio
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Copyright (c) 2019 Journal of Clinical Medicine Hue Central Hospital