Pasos técnicos y resultados postoperatorios de la resección anterior baja con TTSS

Pasos técnicos y resultados postoperatorios de la resección anterior baja con transección transanal y grapado simple (técnica TTSS)

Technical steps and postoperative results of low anterior resection with transanal transection and simple stapling (TTSS technique)

A. Vivas López*, O. García Villar*, J. García Borda*, E. Rubio González*, C. Nevado García*, P. Peláez Torres*, M. Labalde Martínez*, D. Alias Jiménez*, K. Falcon Bonilla*, S. Lorenzo Mañas*, E. Ferrero Herrero*

* Servicio de Cirugía General, Aparato Digestivo y Trasplante de
     Órganos Abdominales. Unidad de Cirugía Colorrectal.
     Hospital Universitario 12 de Octubre. Madrid (España).

DOI: https://doi.org/10.14679/3509

Resumen:

Introducción: El cáncer de recto (CR) presenta múltiples desafíos quirúrgicos debido a su complejidad técnica. La técnica de doble grapado (DG), el estándar actual para la anastomosis colorrectal, se ha asociado con notables inconvenientes, incluido en algunas series una alta tasa de fuga anastomótica (FA). La técnica TTSS surge como una opción para intentar corregir estos inconvenientes. Material y métodos: Estudio observacional que describe los aspectos técnicos y los resultados del grupo inicial de pacientes con CR medio y bajo, sometidos a una resección total del mesorrecto (EMT) laparoscópica y técnica TTSS. Resultados: Se incluyeron 23 pacientes en la serie. Los resultados postoperatorios fueron favorables, con una estancia hospitalaria media de 5 días e incidencia de FA del 8.6%. Es importante destacar que todos los pacientes lograron una escisión mesorrectal completa con márgenes libres de tumor y no hubo mortalidad en la serie. Discusión y conclusión: La TTSS surge como una alternativa prometedora para pacientes con tumores de recto medio e inferior, ofreciendo posibles beneficios en términos de reducción de morbilidad y resultados oncológicos en comparación con otras técnicas.
Palabras clave: Cirugía de cáncer de recto, TTSS, fuga anastomótica, anastomosis con grapado simple.

Abstract:

Introduction: Rectal cancer (RC) presents multiple surgical challenges due to its technical complexity. The double stapling (DG) technique, the current standard for colorectal anastomosis, has been associated with notable drawbacks, including a high rate of anastomotic leak (AL) in some series. The TSS technique emerges as an option to try to correct these drawbacks. Material and Methods: Observational study that describes the technical aspects and results of the initial group of patients with medium and low RC, undergoing laparoscopic total mesorectal resection (TME) and the TSS technique. Results: A total of 23 patients were included in the series. Postoperative results were favorable, with a mean hospital stay of 5 days and an incidence of AL of 8.6%. Importantly, all patients achieved a complete mesorectal excision with tumor-free margins, and there was no mortality in the series. Discussion and Conclusion: The TTSS technique emerges as a promising alternative for patients with middle and lower rectal tumors, offering potential benefits in terms of reduced morbidity and oncological outcomes compared to other techniques.
Key words: Rectal cancer surgery, TTSS, anastomotic leak, simple stapled anastomosis.

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