Background: Total mesorectal excision (TME) remains the gold standard for the resection of rectal cancer regardless of the modality: open, laparoscopic, or robotic. The transanal TME (TaTME) approach has been utilized to overcome the difficulties encountered with the dissection of tumors in the distal pelvis. Recently, a single-port robotic approach (rSPa) was introduced, where three arms and a camera emanate from a 2.5 cm diameter port. This report presents the first experience in the United States combining those two approaches (rSPa TaTME) in rectal cancer, evaluating its safety and oncologic outcomes.Methods: This is a retrospective review of our prospectively maintained rectal cancer database. Patient demographics, tumor characteristics, neoadjuvant treatment, and oncologic and surgical outcomes were recorded.Results: Between May 2022 and August 2024, ten patients (six females, four males) with a median age at surgery of 53 years (range: 38–85) and a mean BMI of 26 (±5) kg/m2were included for analysis. The median distance of tumors from the anorectal junction was 3.2 cm (range: 2–5.3 cm). All patients had negative margins, with eight complete TME specimens, one near complete, and one incomplete. The mean number of lymph nodes harvested was 24 (±11). The average operative time was 351 (243–411) min. The average length of stay was four days. The ileostomy was reversed in nine out of ten patients. Six patients experienced complications within 30 days of surgery. There were no local or distal recurrences, with a mean follow-up of 20 months (range: 4–30).Conclusions: rSPa TaTME is a unique and innovative method of combining two minimally advanced approaches for the resection of distal rectal cancers, with acceptable surgical and oncologic outcomes.
背景：无论采用开放、腹腔镜还是机器人手术方式，全直肠系膜切除术（TME）仍是直肠癌切除的金标准。经肛TME（TaTME）方法被用于克服远端盆腔肿瘤解剖中的困难。近期，单孔机器人手术（rSPa）被引入，其三个机械臂和摄像头均通过一个直径2.5厘米的孔道进行操作。本报告首次介绍了美国结合这两种方法（rSPa TaTME）治疗直肠癌的实践经验，并评估其安全性和肿瘤学结果。 方法：本研究对我们前瞻性维护的直肠癌数据库进行回顾性分析。记录了患者人口统计学特征、肿瘤特征、新辅助治疗情况以及肿瘤学和手术结果。 结果：2022年5月至2024年8月期间，共纳入10例患者（女性6例，男性4例）进行分析，手术中位年龄为53岁（范围：38-85岁），平均体重指数为26（±5）kg/m²。肿瘤距肛直肠连接处的中位距离为3.2厘米（范围：2-5.3厘米）。所有患者切缘均为阴性，其中8例获得完整TME标本，1例接近完整，1例不完整。平均淋巴结获取数量为24（±11）枚。平均手术时间为351分钟（范围：243-411分钟）。平均住院时间为4天。10例患者中有9例成功还纳回肠造口。6例患者在术后30天内出现并发症。平均随访20个月（范围：4-30个月），未发现局部或远处复发。 结论：rSPa TaTME是一种独特且创新的方法，将两种微创先进技术相结合用于远端直肠癌切除，其手术和肿瘤学结果均可接受。
Combined TaTME with SP Robot for Low Anterior Resection in Rectal Cancer: rSPa TaTME
肿瘤(癌症)患者之家