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Journal articles
A Step Toward NOTES Total Mesorectal Excision for Rectal Cancer
Abstract : Background: Previous publications have suggested that endoscopic transanal
proctectomy (ETAP) is a promising technique and may be an alternative to
conventional low anterior resection for rectal cancer. The aim of this study
was to evaluate the technical feasibility of ETAP, with a particular focus on
postoperative and oncological results and on functional outcomes.
Methods: This study was a multicenter prospective study of unselected consecutive patients with low rectal cancer requiring proctectomy and coloanal
anastomosis. All patients underwent a standardized procedure. The study endpoints were the safety and adequacy of the oncological resection criteria. All
patients were evaluated with the Wexner Fecal Incontinence Questionnaire
after stoma closure.
Results: Fifty-six consecutive patients (41 men) underwent ETAP between
February 2010 and June 2012. The median age was 65 years (39–83), and
the median body mass index was 27 (20-42). No intraoperative complications
were encountered. There was no postoperative mortality, and the morbidity
rate was 26%. The mesorectum was complete in 47 cases (84%) and nearly
complete in 9 cases (16%). The median number of lymph nodes retrieved
was 12 (range, 7–29) per patient. The median radial and distal margins were
8 mm (0–20) and 10 mm (3–40), respectively. R0 resection was achieved in
53 patients (94.6%). The median Wexner score was 4 (3–12). Thirteen (28%)
patients reported stool fragmentation and difficult evacuation.
Conclusions: ETAP is a feasible alternative surgical option to conventional
laparoscopy for rectal resection and may represent a promising step toward
rectal natural orifice transluminal endoscopic surgery (NOTES).
https://hal-normandie-univ.archives-ouvertes.fr/hal-02372765
Contributor : Sabine Douville <>
Submitted on : Wednesday, November 20, 2019 - 3:44:19 PM
Last modification on : Sunday, October 25, 2020 - 7:05:20 AM
Contributor : Sabine Douville <>
Submitted on : Wednesday, November 20, 2019 - 3:44:19 PM
Last modification on : Sunday, October 25, 2020 - 7:05:20 AM
