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ORIGINAL RESEARCH article

Front. Surg.
Sec. Surgical Oncology
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1419675

Transanal intersphincteric under direct view in the jackknife position combined with laparoscopic total mesorectal excision for treating ultra-low rectal cancer

Provisionally accepted
Guobin Zhong Guobin Zhong Zhiyu Chen Zhiyu Chen Zhenfeng Li Zhenfeng Li Bin Zhao Bin Zhao Junhui Deng Junhui Deng *
  • Huizhou Central People's Hospital, Huizhou, China

The final, formatted version of the article will be published soon.

    To investigate the effect and clinical advantage of transanal intersphincteric (ISR) under direct view in the jackknife position combined with laparoscopic total mesorectal excision (TME) for treating ultra-low rectal cancer. Additionally, the feasibility of this surgical technique was evaluated.Method: This was a retrospective, single-center, single-arm pilot study. Ten patients with ultra-low rectal cancer underwent treatment by the same surgical team for direct view transanal ISR combined with laparoscopic TME in the Department of Anorectal Surgery, Huizhou Central People's Hospital between January 2021 and June 2021. The relevant clinical data were collected and analyzed.Results: All the patients underwent complete mesenteric resection without conversion to laparotomy. The circumferential and distal resection margins (CRM and DRM) were negative. The mean distance between the lower margin of the tumor and the anal margin was 2.8± 0.8 cm, and the mean margin of distal resection was 1.2± 0.2 cm. TNM pathological stages I, II, III, and IV were observed in 6, 2, 2, and 0 cases, respectively. The median follow-up period was 15 months (interquartile range, 8 months). The mean Wexner and Low Anterior Resection Syndrome scores at 12 months after ileostomy were 8.1±2.1 and 22.4±5.7, respectively.Transanal ISR under direct view in the jackknife position combined with laparoscopic TME is safe and feasible for the treatment of ultralow rectal cancer.

    Keywords: Jackknife position, Intersphincteric, the level of the levator anal hiatus, Ultra-low rectal cancer, Total mesorectal excision

    Received: 18 Apr 2024; Accepted: 27 Aug 2024.

    Copyright: © 2024 Zhong, Chen, Li, Zhao and Deng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Junhui Deng, Huizhou Central People's Hospital, Huizhou, China

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