Indication of transanal down-to-up rectal dissection combined with lap-SPS for RC near the anus

Satoru Kagami; Kimihiko Funahashi; Takamaru Koda; Toshimitsu Ushigome; Tomoaki Kaneko; Takayuki Suzuki; Yasuyuki Miura; Yasuo Nagashima; Kimihiko Yoshida; Akiharu Kurihara

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Indication of transanal down-to-up rectal dissection combined with lap-SPS for RC near the anus

SK Satoru Kagami

KF Kimihiko Funahashi

TK Takamaru Koda

TU Toshimitsu Ushigome

TK Tomoaki Kaneko

TS Takayuki Suzuki

YM Yasuyuki Miura

YN Yasuo Nagashima

KY Kimihiko Yoshida

AK Akiharu Kurihara

This method is extracted from research article: World J Surg Oncol, Nov 2022

Transanal down-to-up dissection of the distal rectum as a viable approach to achieve total mesorectal excision in laparoscopic sphincter-preserving surgery for rectal cancer near the anus: a study of short- and long-term outcomes of 123 consecutive patients from a single Japanese institution

DOI: 10.1186/s12957-022-02826-5

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We chose transanal down-to-up rectal dissection to perform lap-SPS for RC near the anus. Intersphincteric resection (ISR) was indicated for lesions <5 cm from the anal verge, excluding clinical stage IV cancer cases. According to the UICC TNM classification of malignant tumors, we first evaluated clinical TNM staging using enhanced CT and magnetic resonance imaging (MRI). For locally advanced tumors with clinical stage N2-3 and/or suspected direct invasion to adjacent organs (including the prostate, vagina, and levator ani muscle), we administered chemoradiation therapy (CRT) with S-1 or neoadjuvant chemotherapy (NAC) before surgery. Subsequently, we evaluated the final TNM staging using enhanced CT and MRI. Patients with obvious findings of direct invasion to adjacent organs were excluded from the indication of lap-SPS with transanal mobilization and underwent rectal amputation instead.

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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