Using taTME to maintain restorative options in locally advanced rectal cancer: A technical note

• Published in: International journal of surgery case reports Vol. 73; pp. 39 - 43
• Main Authors: Larach, José Tomás, Waters, Peadar S., McCormick, Jacob J., Heriot, Alexander G., Smart, Philip J., Warrier, Satish K.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-01-2020; Elsevier
• Subjects: En-bloc vaginal wall resection; Extended resection; R0 resection; Rectal cancer; taTME; Transanal total mesorectal excision; En-bloc vaginal wall resection; Extended resection; Rectal cancer; Transanal total mesorectal excision; R0 resection; taTME
• DOI: 10.1016/j.ijscr.2020.06.015
• EISSN: 2210-2612

•The safe adoption of transanal total mesorectal excision (taTME) has occurred in many countries worldwide.•Planes beyond TME can be utilised in more advanced cases to achieve negative margins during transanal dissection.•In this case, the transanal technique allowed the surgeons to ensure organ preservation and control the R1 risk point during dissection.•An R0 resection was achieved.•This technical note highlights that in experienced hands, taTME can be safely implemented to maintain restorative options in locally advanced rectal cancer requiring resection beyond the mesorectal plane.
The safe adoption of transanal total mesorectal excision (taTME) has occurred in Australasia as previously reported by the current authors. Planes beyond TME can be utilised in more advanced cases to achieve negative margins during transanal dissection.
In this article we describe how taTME is used to perform an en-bloc partial vaginectomy and aid restore intestinal and vaginal continuity in a young female with a locally advanced rectal cancer and posterior vaginal wall involvement in the pre-treatment magnetic resonance imaging.
The transanal technique allowed the surgeons to remove a disc of vagina, ensure organ preservation and control the main R1 risk point. An R0 resection was achieved.
This technical note highlights that in experienced hands, taTME may be safely implemented to maintain restorative options in locally advanced rectal cancer requiring resection beyond the total mesorectal excision plane.