New surgical techniques allow better and more precise resection of rectal tumors near the anus


Posted 22/01/2019 14:20:08CET


New surgical techniques allow better visualization and resection of more rectal tumors right near the anus, explained Dr. Óscar Alonso, gastrointestinal surgical oncologist at MD Anderson Madrid, who points out that the main problem so far is the "drawback". vision of the most distal part of the rectum, which makes correct and complete tumor resection difficult ".

The usual treatment for rectal cancer consists of total excision of the mesorectum, that is, removal of the rectum plus surrounding fat and lymph nodes, an effective approach that can be carried out by laparotomy (open surgery), by laparoscopy or by assisted surgery. with robots.

The problem with this approach is, Alonso explained, that when the location of the tumor gets closer to the anus and, therefore, vision deteriorates, the patient is more likely that the resection is incorrect and the tumor recurs.

The new technique for total mesorectal excision with a transanal route (TATME) comes right to try to solve this vision problem. Performed in combination with traditional techniques of surgical mesorectum excision with laparotomy, laparoscopy or assisted by robots, TATME allows to supply a lack of vision at the farthest part of the rectum and, therefore, reaches more patients with localized cancer of the rectum. very close to the anus (those who usually undergo a definitive colostomy) have the option of undergoing a temporary ileostomy.

"When we approach the anus, the pelvis narrows, as if it were & # 39; so that the vision of the last part of & # 39; L & # 39; this is more complicated," said the doctor. Therefore, instead of entering from above, with TATME you can enter from below, from that year, also with laparoscopic instruments. "Through the anus, we move towards the rectum, where we make a circular incision to, from there, access the pelvis and then do a total excision of mesorectum," he explained.

During the intervention, there may be two professional teams, each of which is responsible for choosing one section & # 39; L & # 39; or one single team, which will start with the longest section of & # 39; L & # 39; to be followed, then, with the shortest part.

In non-obese patients with small tumors, this technique even allows the extraction of tumors from the anus, so that "there is no need to extract through the stomach, an approach that usually requires an incision of 5-7 cm above the pubis", highlighting Dr. Alonso.

Alonso emphasized improving the quality of life of these patients, who achieved more complete resection with less invasive interventions. "Recovery of patients occurs much earlier and, therefore, also improves their quality of life," he concluded.


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