Feasibility of transanal minimally invasive surgery for total pelvic exenteration for advanced primary and recurrent pelvic malignancies.
Tech Coloproctol
; 27(12): 1367-1375, 2023 12.
Article
in En
| MEDLINE
| ID: mdl-37878167
ABSTRACT
BACKGROUND:
The purpose of this study was to clarify the efficacy and safety of transanal minimally invasive surgery (TAMIS) for total pelvic exenteration (TPE) in advanced primary and recurrent pelvic malignancies.METHODS:
Using a prospectively collected database, we retrospectively analyzed the clinical, surgical, and pathological outcomes of TAMIS for TPE. Surgery was performed between September 2019 and April 2023. The median follow-up period was 22 months (2-45 months).RESULTS:
Fifteen consecutive patients were included in this analysis MF = 141 and median (range) age was 63 (36-74). Their diagnoses were as follows primary rectal cancer (n = 5; 33%), recurrent rectal cancer (n = 4; 27%), primary anorectal cancer (n = 5; 33%), and gastrointestinal stromal tumor (n = 1; 7%). Bladder-sparing TPE was selected for two patients (13%). In nine of 15 patients (60%) the anal sphincter could be successfully preserved, five patients (33%) required combined resection of the internal iliac vessels, and two (13%) required rectus muscle flap reconstruction. The median operative time was 723 min (561-1082), and the median intraoperative blood loss was 195 ml (30-1520). The Clavien-Dindo classifications of the postoperative complications were as follows grade 0-2 (n = 11; 73%); 3a (n = 3; 20%); 3b (n = 1; 7%); and ≥ 4 (n = 0; 0%). No cases of conversion to laparotomy or mortality were observed. The pathological results demonstrated that R0 was achieved in 14 patients (93%).CONCLUSIONS:
The short-term outcomes of this initial experience proved that this novel approach is feasible for TPE, with low blood loss, acceptable postoperative complications, and a satisfactory R0 resection rate.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Anus Neoplasms
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Pelvic Exenteration
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Pelvic Neoplasms
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Rectal Neoplasms
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Carcinoma
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Transanal Endoscopic Surgery
Limits:
Humans
Language:
En
Journal:
Tech Coloproctol
Journal subject:
GASTROENTEROLOGIA
Year:
2023
Document type:
Article
Affiliation country: