Anatomic factors and preventive techniques for anastomotic complications after transanal total mesorectal excision

VernacularTitle: 经肛全直肠系膜切除术吻合口并发症的相关解剖因素及预防技巧
Author: Jinchun CONG ¹ ; Hong ZHANG
Author Information

1. Department of Colorectal Tumor Surgery, Shengjing Hospital, China Medical University, Shenyang 110004, China
Publication Type:Journal Article
Keywords: Rectal neoplasms; Transanal total mesorectal excision; Anastomosis; Complication
From: Chinese Journal of Gastrointestinal Surgery 2019;22(8):724-728
CountryChina
Language:Chinese
Abstract: Whether the transanal total mesorectal resection (taTME) techniques increase the risk of anastomotic failure is inconclusive. This paper discusses the anastomotic problems of taTME from different aspects including anatomical factors and technical characteristics. In terms of the anatomic and physiological characteristics of the lower rectum, the Hiatal ligament and the density of the perirectal space is a disadvantage to the anastomosis of taTME, while the prolapse of the rectum may be a beneficial factor. Due to the unique technical characteristics of taTME, the main reason affecting its anastomosis at present is that the caudal space at the distal end is not sufficiently mobilized, especially for male and lower anastomosis. In addition, stapled anastomosis at the level of anorectal ring may cause more problems, while manual anastomosis at the lower level may bring better results.