title: Transanal Total Mesorectal Excision With Single-Incision Laparoscopy for Rectal Cancer.
abstract: OBJECTIVE
  There has been great enthusiasm for the technique of transanal total mesorectal excision. Coupled with this procedure, we performed single-incision laparoscopic surgery for left colon mobilization. This is a description of our initial experience with the combined approach.
  
  
  METHODS
  Patients with distal or mid rectal cancer were included. The operation was performed by 2 teams: one team performed the single-incision mobilization of the left colon via the right lower quadrant ileostomy site, and the other team performed the total mesorectal excision with a transanal platform.
  
  
  RESULTS
  During the study period, 10 patients (5 men) with cancer of the rectum underwent the surgery. The mean age was 62.2 ± 11.1 years, and the mean body mass index was 23.4 ± 3.2 kg/m(2). The tumor's mean distance from the anal verge was 5.1 ± 2.5 cm. The median operating time was 247.5 minutes (range, 188-462 minutes). The mean estimated blood loss was 124 ± 126 mL (range, 10-188 mL). Conversion to multiport laparoscopy was needed in one case (10%). Postoperative pain, as reflected by the pain score, was minimal. The mean number of lymph nodes harvested was 15.6 ± 3.8. All specimens had clear distal and circumferential radial margins. The overall complication rate was 10%.
  
  
  CONCLUSIONS
  Our experience showed transanal total mesorectal excision with single-incision laparoscopy to be a feasible option for rectal cancer. Patients reported minimal postoperative pain. Further studies on the long-term outcome are warranted.
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Dominic Chi-Chung
authors.initials: DC
authors.lastname: Foo
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Hok Kwok
authors.initials: HK
authors.lastname: Choi
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Rockson
authors.initials: R
authors.lastname: Wei
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Yip
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Wai Lun
authors.initials: WL
authors.lastname: Law
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D003106:Colon / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D010348:Patient Care Team; D011351:Proctoscopy / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*
keywords: Rectal cancer; Single-incision laparoscopy; TAMIS; Transanal total mesorectal excision