Benjamin Sejr Thinggaard* and Sharaf Karim Perdawood
Department of Surgery, Slagelse Hospital, DenmarkFulltext PDF
Background: Total Mesorectal Excision (TME) is widely accepted as the standard surgical treatment for mid and low rectal cancer. The Robotic (RoTME) and Laparoscopic (LaTME) approaches to treat rectal cancer are shown to be feasible. Transanal TME (TaTME) is the most recent minimal invasive approach with promising results. We aimed to review the peri and postoperative complications associated with the three approaches.Methods: A systematic search in the PubMed and Embase databases was performed. Both authors assessed the studies for eligibility. Clinical randomized as well as non-randomized studies published during the last six years were included.Results: In total 39 studies (8094 patients) met the inclusion criteria. The LaTME had low rates of urinary complications, high rates of wound infection and intraabdominal abscesses. The RoTME had high rates of anastomotic leakages, but low rates of several other complications like; ureter and bladder injuries, bleeding and thirty-day mortality. The anastomosis performed more efficiently after TaTME with lower rates of anastomotic leakages, but higher rates of bleeding and 30-days mortality.Conclusion: The procedures each performed well in relation to the different complications however further research especially concerning TaTME and RoTME is needed. Focus on which procedure that best treats a specific tumor stage, tumor location and type of patient could possibly reduce complications and postoperative mortality in the future.
Rectal cancer; Complications; Total mesorectal excision; Transanal; Robot-assisted surgery; Laparoscopic surgery
Thinggaard BS, Perdawood SK. Complications of Minimal Invasive Surgery for Rectal Cancer - A Systematic Review. Clin Surg. 2017; 2: 1818.