title: Transanal total mesorectal excision for restorative coloproctectomy in an obese high-risk patient with colitis-associated carcinoma.
abstract: Transanal total mesorectal excision (TaTME) offers great potential for the treatment of malign and benign diseases. However, laparoscopic-assisted TaTME in ulcerative colitis has not been described in more than a handful of patients. We present a 47-year-old highly comorbid female patient with an ulcerative colitis-associated carcinoma of the ascending colon and steroid- refractory pancolitis. A two-stage restorative coloproctectomy including right-sided complete mesocolic excision was conducted. The second step consisted of a successful nerve-sparing TaTME and a handsewn ileal pouch-anal anastomosis. TaTME may extend the possible treatment options in inflammatory bowel disease, especially for high-risk patients.
authors.affiliation: a Department of General, Visceral and Transplant Surgery , University Medical Center of the Johannes Gutenberg-University Mainz , Germany.
authors.forename: Laura Isabel
authors.initials: LI
authors.lastname: Hanke
authors.affiliation: a Department of General, Visceral and Transplant Surgery , University Medical Center of the Johannes Gutenberg-University Mainz , Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Bartsch
authors.affiliation: b Institute of Pathology, University Medical Center of the Johannes Gutenberg-University , Mainz , Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Försch
authors.affiliation: c Department of Anaesthesiology , University Medical Center of the Johannes Gutenberg-University , Mainz , Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Heid
authors.affiliation: a Department of General, Visceral and Transplant Surgery , University Medical Center of the Johannes Gutenberg-University Mainz , Germany.
authors.forename: Hauke
authors.initials: H
authors.lastname: Lang
authors.affiliation: a Department of General, Visceral and Transplant Surgery , University Medical Center of the Johannes Gutenberg-University Mainz , Germany.
authors.forename: Werner
authors.initials: W
authors.lastname: Kneist
mesh_terms: D001003:Anal Canal; D000714:Anastomosis, Surgical / Q000379:methods; D003093:Colitis, Ulcerative / Q000150:complications* / Q000601:surgery; D003110:Colonic Neoplasms / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012007:Rectum / Q000601:surgery; D012306:Risk
keywords: Ulcerative colitis–associated carcinoma; minimally invasive surgery; total mesorectal excision; transanal minimally invasive surgery; transanal total mesorectal excision