Pure transanal endoscopic colectomy for ascending colon cancer
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Pure transanal endoscopic colectomy for ascending colon cancer L. Huang1,2,3 · X. Zhang1,2,3 · Z. Zeng1,2,3 · H. Hu1,2,3 · L. Kang1,2,3 Received: 4 February 2020 / Accepted: 14 June 2020 © Springer Nature Switzerland AG 2020
Abstract Background Previous studies have demonstrated that pure transanal endoscopic surgery is safe and feasible in the treatment of rectal cancer. However, the role of pure transanal endoscopic colectomy in ascending colon cancer (ACC) treatment has not been evaluated. We report a case of transanal endoscopic surgery for ACC. Methods A 35-year-old woman was treated for ACC, using a transanal endoscopic surgery device as the operation platform, and pure transanal endoscopic right hemicolectomy without transabdominal assistance was safely performed. An instrument suture, side-to-side, ileocolic anastomosis was performed. Operative time was 245 min and intraoperative blood loss was 60 ml. Results The patient recovered well from the surgery. Compared with the traditional approach, this approach was less invasive and resulted in satisfactory outcomes and cosmesis (no scar). Conclusions Application of pure transanal endoscopic colectomy without abdominal assistance to ACC appears to be feasible and safe. Keywords Ascending colon cancer · Transanal endoscopic colectomy · Natural orifice transluminal endoscopic surgery
Introduction Currently the gold standard for an oncological resection of the ascending colon cancer (ACC) is either transabdominal laparoscopy or laparotomy. As the authors all known performing a pure transanal total mesorectal excision (taTME) with a retroperitoneal dissection is feasible [1]. With pure transanal endoscopic surgery, access to colorectal lesions is gained through the anus, without transabdominal assistance [2]. The feasibility and safety of pure taTME in the treatment of rectal cancer has been proved by several studies [3, 4], and this procedure was consistent with the concept of natural * L. Kang [email protected] 1
Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
2
Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
3
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
orifice transluminal endoscopic surgery (NOTES). However, to the best of the authors knowledge, no study in the literature has reported that a pure transanal endoscopic platform was used in the treatment of ACC. The transanal endoscopic procedure was performed successfully on a female patient with ACC.
Materials and methods A 30-year-old female was admitted to the hospital with 2-month history of bloody stools. Although anemic she was otherwise medically fit, a non-smoker, and had no special medical history. A computed tomography (CT) scan of the
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