Prerequisites for Safe Implementation of Transanal Total Mesorectal Excision.

08:00 EDT 1st August 2019 | BioPortfolio

Summary of "Prerequisites for Safe Implementation of Transanal Total Mesorectal Excision."

Transanal total mesorectal excision (TaTME) is an innovative and technically demanding surgical approach for the treatment of rectal cancer. This review summarises the international consensus statements on prerequisites and training requirements for safe implementation of this complex procedure. Recommendations will be discussed on the basis of the published surveys from dedicated training centres. Furthermore, experience is shared on mentored TaTME cadaveric courses (video) and an initial clinical series of 102 TaTMEs. The procedure should be performed primarily by postgraduate colorectal surgeons. Initially, a structured training program at designated training centers is mandatory. Cadaver training and proctoring are the central elements required to ensure safe implementation of TaTME in clinical practice. However, validation of TaTME training concepts needs further work. Evaluation of the first pioneering series indicates a learning phase with at least 40 operations. Above the cut-off, lower complication rates and acceptable quality of specimen are achieved. In our series, morbidity decreased significantly (Clavien-Dindo ≥ 
29 vs. 9%). With the indication for TaTME, we find a median of 6 risk factors (4 - 8) for an unfavourable outcome after abdominal TME alone. Only high volume centres with a concentration of appropriately selected patients could aim for a proposed TaTME frequency of 20 per year. Structured training programs for TaTME are justified and must be completed before implementation in clinical practice. The case volume effect for the learning curve and individual patient selection are crucial and support the concentration of the new method in high volume centres.


Journal Details

This article was published in the following journal.

Name: Zentralblatt fur Chirurgie
ISSN: 1438-9592
Pages: 408-418


DeepDyve research library

PubMed Articles [10194 Associated PubMed Articles listed on BioPortfolio]

Laparoscopy-Assisted Transanal Total Mesorectal Excision.

Rectal cancer located in distal third still remains a technical challenge for surgeons. Transanal total mesorectal excision with laparoscopic assistance is quite new surgical approach for rectal cance...

The usefulness of intraoperative X-ray fluoroscopy in avoiding urethral injury during transanal total mesorectal excision.

Urethral injury is one of the most important complications that can occur during transanal total mesorectal excision in male patients with rectal cancer. This report shows the usefulness of intraopera...

A nationwide study on the adoption and short-term outcomes of transanal total mesorectal excision in the UK.

The interest and adoption of transanal total mesorectal excision (TaTME) is growing worldwide, but evidence on nationwide implementation and short-term outcomes is scarce. This study aims to evaluate ...

Anastomotic leak after transanal Total Mesorectal Excision (TaTME): Grading of severity and management aimed at preservation of the anastomosis.

The transanal approach to total mesorectal excision (TaTME) as alternative to conventional anterior resection offers an improved view to otherwise restricted anatomical regions in obese and narrow mal...

Head-Mounted Mixed-Reality Technology During Robotic-Assisted Transanal Total Mesorectal Excision.

Head-mounted mixed-reality technologies may enable advanced intraoperative visualization during visceral surgery. In this technical note, we describe an innovative use of real-time mixed reality durin...

Clinical Trials [6934 Associated Clinical Trials listed on BioPortfolio]

Transanal Versus Laparoscopic Total Mesorectal Excision for Rectal Cancer

This study is designed to evaluate the short-term and long-term results after transanal total mesorectal excision (TaTME) for the resection of mid and low rectal cancer compared with lapar...

Evaluation of the Safety and the Efficacy of Transanal TME in Difficult Cases

The purpose of this study is evaluation of the safety and the efficacy of transanal total mesorectal excision in difficult case. Difficult case is defined as below; - If any one of...

Outcomes of TAMIS-TME Versus Transanal Loco-regional Excision for T2 Low Rectal Cancer

Cases with stage T2 N0 low rectal cancer will undergo either Transanal minimally invasive total mesorectal excision or transanal minimally invasive locoregional resection.

Robotic Assisted Transanal Total Mesorectal Excision Surgery for Rectal Cancer in Low Site

To investigates the feasibility, practicability, safety and subjective as well as functional outcome of Robotic transanal total mesentery excision for rectal cancer in low site.

Minimally Invasive Sphincter Sparing Total Mesorectal Excision for Ultra-low Rectal Cancer After Initial Chemo-radiotherapy (MISS-TRICR).

A prospective study is planned for managment of low rectal cancer with the aim of sphincter preservation and improving the oncological outcome of the patients, through comparing of both ap...

Medical and Biotech [MESH] Definitions

A specialized form of transanal endoscopic surgery for microscopically controlled operations in the RECTUM.

A surgical procedure involving the excision of the COLON and RECTUM and the formation of an ILEOANAL RESERVOIR (pouch). In patients with intestinal diseases, such as ulcerative colitis, this procedure avoids the need for an OSTOMY by allowing for transanal defecation.

Total or partial excision of the larynx.

The sum total of measures taken and regulatory policies enacted to ensure the safe use of consumer products.

Strategies required by the US Food and Drug Administration (FDA) Amendments Act of 2007 when a question exists as to whether the benefits of a drug outweigh its risks. These constitute a safety plan with several potential components, including a medication guide, a communication plan, elements to ensure safe use and an implementation system to help guide the prescribers, pharmacists and patients.

Quick Search

DeepDyve research library

Relevant Topics

Surgical treatments
Surgery is a technology consisting of a physical intervention on tissues. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being exci...

  Bladder Cancer Brain Cancer Breast Cancer Cancer Cervical Cancer Colorectal Head & Neck Cancers Hodgkin Lymphoma Leukemia Lung Cancer Melanoma Myeloma Ovarian Cancer Pancreatic Cancer ...

Searches Linking to this Article