Literature ta tme
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This document summarizes several studies on transanal total mesorectal excision (TaTME) surgery: - Studies from 2010-2009 evaluated TaTME techniques with small patient numbers, including laparoscopic disc and lone star retractor approaches. - Leroy 2013 and Colombo 2015 compared TaTME to robotic surgery. - COLOR I and II were large, matched control studies comparing laparoscopic to open colon and rectal cancer surgery, finding short-term benefits to laparoscopic. - COLOR III is an ongoing study directly comparing laparoscopic TME to TaTME.
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This document provides information on equipment and setup for a transanal total mesorectal excision (TME) procedure performed by both abdominal and perineal surgical teams. It discusses using either a synchronous approach with two teams and towers operating simultaneously, or a sequential approach with one team operating at a time. Key equipment mentioned for the perineal team includes a Lonestar retractor, Gelpoint Path access system, monopolar hook, Airseal trocar, fenestrated grasper, and a hemorrhoidal stapler. Maintaining pneumoperitoneum and smoke evacuation in the perineal space is important and can be achieved through use of an Airseal device.
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This document provides information on equipment and setup for a transanal total mesorectal excision (TME) procedure performed by both abdominal and perineal surgical teams. It discusses using either a synchronous approach with two teams and towers operating simultaneously, or a sequential approach with one team operating at a time. Key equipment mentioned for the perineal team includes a Lonestar retractor, Gelpoint Path access system, monopolar hook, Airseal trocar, fenestrated grasper, and a hemorrhoidal stapler. Maintaining pneumoperitoneum and smoke evacuation in the perineal space is important and can be achieved through use of an Airseal device.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Literature ta tme
- 1. Overview of the literature Y. Van Nieuwenhove
- 2. BSW 2012 • Tuech JJ (Rouen) ETAP • 2010 Lacy (Barcelona), Marks (Wynnewood) • 2009 Funahashi K (Tokyo) 6pts – Lone Star – Lap disc mini • 2007 Köninger J (Heidelberg) – Partial posterior PME transperineal
- 3. Series >10pt
- 5. Parallel • Leroy 2013 Total pure NOTES TaTME – Transanal mobilisation of splenic flexure • Colombo 2015 – Robotic TME or TaTME • Atallah 2014 – RATS TME (3cases)
- 6. COLOR • COLOR I: 627 lap colon-621 open colon – Lancet Oncol 2005, 2009 – Better short term, similar long term • COLOR II: 699 lap – 345 open rectal ca – NEJM 2015
- 7. COLOR III • ±1000pts – Lap TME vs TaTME – ongoing