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dc.contributor.authorLarach, José Tomás-
dc.contributor.authorRajkomar, Amrish Ks-
dc.contributor.authorSmart, Philip J-
dc.contributor.authorMcCormick, Jacob J-
dc.contributor.authorHeriot, Alexander G-
dc.contributor.authorWarrier, Satish K-
dc.identifier.citationColorectal Disease 2021; 23(4): 823-833en
dc.description.abstractTo define the role of transanal total mesorectal excision (taTME) in locally advanced rectal cancer (LARC) requiring resection beyond the mesorectal plane. Retrospective review of the outcomes of a case series of patients undergoing taTME for rectal cancer with mesorectal fascia or adjacent organ involvement,. Eleven patients (6 males) underwent transanal total mesorectal excision (taTME) for locally advanced rectal cancer requiring resection beyond total mesorectal excision. All had a restorative procedure. The transabdominal approach was open in five and minimally invasive in six cases. All patients required the resection of at least one adjacent structure including presacral fascia, internal iliac vessels, nerve roots, uterus, vagina or seminal vesicles. Four patients required a pelvic side-wall lymph node dissection and four had intraoperative radiotherapy. In all cases, the transanal approach was useful to disconnect the rectum distally, resect adjacent organs, or control the R1 risk-point. Three patients had Clavien-Dindo ≥ III or more complications (one mechanical bowel obstruction, one pelvic collection and one urine sepsis). There were no anastomotic complications. Ten patients had an R0 resection. During a median follow-up of 11 (8.6-16) months, there were no local recurrences but two patients had distant metastases. During the study period, eight patients underwent closure of their stoma, whilst the remaining three have had normal anastomotic assessments and will be closed in the future. This early series shows that implementation of taTME for resections beyond total mesorectal excision may be feasible and safe in a highly selected setting.en
dc.subjectTotal mesorectal excisionen
dc.subjectextended resectionen
dc.subjectrectal canceren
dc.subjecttransanal TMEen
dc.titleBeyond transanal total mesorectal excision: short-term outcomes of transanal total mesorectal excision in locally advanced rectal cancer requiring resection beyond total mesorectal excision.en
dc.typeJournal Articleen
dc.identifier.journaltitleColorectal Diseaseen
dc.identifier.affiliationDepartment of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile..en
dc.identifier.affiliationDivision of Cancer Surgery PeterMacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, Australiaen
dc.identifier.affiliationGeneral Surgery and Gastrointestinal Clinical Institute, Epworth Healthcare, Melbourne, Australiaen
dc.identifier.pubmedid33217140, Philip J
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
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