الفهرس 
ContentsOnly 14 pages are availabe for public view
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Abstract
TaTME has potential benefits of better visual control, especially in male patients with a high body mass index and low rectal cancer. However, this method has not yet been validated in clinical trials. The aim of this study was to evaluate the feasibility, short-term adverse events and oncologic outcomes of Laparoscopic-assisted TaTME of RC. from April 2018 and March 2021, patients undergoing TaTME for rectal cancer were included The analysis focused on operative data and short-term surgical outcomes. Results: from April 2018 and March 2021, 30 taTME procedures were performed,16 males (53.3%) and 14 females (47.7%), with a mean age of 50.43 years.There were 21 patients (70%) with tumors in mid rectum, and 9 patients (30%) with tumors located in the low rectum. Median operative time was 135.27 min . Estimated blood loss was 133.67 ±66.59 ml . Length of hospital stay was 5.27 ± 1.08 days. Total hospital cost was 46.43 ± 1.81 X 1000 L.E.Mesorectal excision was complete in all patients. CRM were negative in all cases.there was only one case that was converted to open approach (3.3%). Overall postoperative complications rate was 6.6% (2 cases).
Postoperative ileus occurred once and anastomotic leakage occurred in one patient experienced hands TaTME is a safe technique, but remains a challenging procedure with little room for error.Once the technique is mastered, transanal surgery can be applied to the most challenging group of RC patients such as the obese patient, a narrow pelvis and low, bulky rectal tumors , and all in which technical difficulty in finding the right planes can be expected.TaTME is not intended to be the choice for every RC patient and case selection is important when considering transanal surgery, TaTME is not meant to replace, but rather complement the other pure abdominal approaches for optimal outcomes in complex RC patients.
Although the experience with this technique is still limited, the preliminary data on short-term oncological outcome is safe and feasible with lower complications using single team approach, intermittent CO2 insufflator and 2D camera with zero scope as well as ordinary laparoscopic instruments.At the end of this study we had the impression of this technique should be used for resection of mid and lower RC as a completion operation after laparoscopic dissection and exposure/protection of ureters and nerves from the abdominal side rather than an operation on its own.We suggest that single team approach is not time consuming (operative time was less than what had been reported by other authors using two team approach) and dissection should be done through the proper plane (TME planes) lateral to urosacral ligament in females and its analogue in males named prostatosacral ligament in order to minimize the incidence of local recurrence.However, a large multicenter trials comparing our suggesting one team approach as compared to the two team approach suggested by Antonio De Lacy in a head to head comparative study is needed before wide spread adoption can be recommended.
Long term results still have to be awaited to show non-inferiority to open surgery and other minimal invasive procedures.