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The usefulness of intraoperative X‐ray fluoroscopy in avoiding urethral injury during transanal total mesorectal excision
Author(s) -
Tokunaga Takuya,
Higashijima Jun,
Yoshikawa Kozo,
Nishi Masaaki,
Kashihara Hideya,
Takasu Chie,
Shimada Mitsuo
Publication year - 2020
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12717
Subject(s) - medicine , fluoroscopy , total mesorectal excision , urethra , surgery , dissection (medical) , radiology , colorectal cancer , cancer
Urethral injury is one of the most important complications that can occur during transanal total mesorectal excision in male patients with rectal cancer. This report shows the usefulness of intraoperative X‐ray fluoroscopy to avoid urethral injury associated with transanal total mesorectal excision. Materials and Surgical Technique Real‐time navigation using fluoroscopy was performed to check the distance between the urethra and the dissection line at the level of the exposed rectourethral muscle, the middle level of the divided rectourethral muscle, and the level at which the prostate was identified. Discussion The dissection was completed transanally up to the level of peritoneal reflection on the anterior side without urethral injury. Pathological examination confirmed that the circumferential resection margin was tumor free. This novel technique using intraoperative X‐ray fluoroscopy is an easy‐to‐use approach that helps prevent urethral injury in male patient who undergo transanal total mesorectal excision for rectal cancer.