title: Transanal total mesorectal excision assisted by single-port laparoscopic surgery for low rectal cancer.
abstract: BACKGROUND
  We have combined the minimally invasive single-port laparoscopic surgery and the transanal total mesorectal excision (TaTME) for rectal cancer with the goal to standardize the approach and improve the quality of rectal cancer resection.
  
  
  METHODS
  By using two single-port platforms, selected patients were first operated by TaTME, and then a single-port laparoscopic surgery was introduced to assist and complete the abdominal portion. Short-term outcomes including perioperative outcome and pathologic results of these patients were evaluated.
  
  
  RESULTS
  Between July 2014 and March 2015, six patients with low rectal cancer (five males and one female) at a median age of 68 years were successfully operated in a median time of 360 min (range 310-420). The median estimated blood loss was 150 ml (range 50-800). In one patient, the spleen was removed because of a lesion identified preoperatively. Their postoperative recovery was uneventful except one acute myocardial infarction on postoperative day 3. Pathologic specimens showed negative margins and a complete excision of the mesorectum in all cases. The median number of harvested lymph nodes was 11.5 (range 4-12). At a median follow-up of 4 months (range 3-9), after ileostomy closure, none of the patients suffered from fecal incontinence.
  
  
  CONCLUSIONS
  TaTME assisted by abdominal single-port may be safely achieved in selected rectal cancer patients.
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, 26 Yuancun Erheng Rd, Guangzhou, 510655, People's Republic of China.
authors.forename: W-H
authors.initials: WH
authors.lastname: Chen
authors.forename: L
authors.initials: L
authors.lastname: Kang
authors.forename: S-L
authors.initials: SL
authors.lastname: Luo
authors.forename: X-W
authors.initials: XW
authors.lastname: Zhang
authors.forename: Y
authors.initials: Y
authors.lastname: Huang
authors.forename: Z-H
authors.initials: ZH
authors.lastname: Liu
authors.forename: J-P
authors.initials: JP
authors.lastname: Wang
mesh_terms: D000005:Abdomen / Q000473:pathology / Q000601:surgery; D000368:Aged; D001003:Anal Canal / Q000473:pathology / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000706:statistics & numerical data; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000473:pathology / Q000601:surgery*; D000067368:Transanal Endoscopic Surgery / Q000379:methods*