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: Report
• Language: English
• Published: 01-01-2020
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2020.06.015

BACKGROUNDThe 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.METHODSIn 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.RESULTSThe 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.CONCLUSIONThis 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.