Innovative biodegradable stents with extension sleeves show promise for rectal cancer surgery.
New technique aims to reduce complications and improve patient outcomes following transanal total mesorectal excision.
Rectal cancer surgeries often face challenges with complications like anastomotic leakage, particularly after procedures such as transanal total mesorectal excision (Ta_tme). This surgery, though innovative, has seen significant rates of leakage leading to infections and extended recovery times. A new approach utilizing biodegradable endoluminal stents connected to extension sleeves is being tested to address these risks for patients considered at high risk for complications.
Recent studies revealed successful outcomes from the use of this technology, with six participants undergoing Ta_tme surgery. None were subjected to prophylactic ileostomy, and they all successfully integrated the new stent system, which was implanted during surgery and disintegrated without complications within weeks, allowing normal fecal passage and mitigating the risks typically associated with rectal surgeries.
"None of the six patients experienced significant complications such as perianal discomfort or leakage during the perioperative period," noted the researchers. They pointed to the success of this approach as not only conducive to reducing the need for more invasive interventions like ileostomy, but also beneficial for enhancing quality of life and minimizing medical costs associated with complications.
Anastomotic leakage concerns are heightened for patients with various risk factors, including obesity and those undergoing neoadjuvant chemoradiotherapy. The polynomialization of this technique sees fecal material being diverted effectively and reduces the complexity of the surgical technique, thereby addressing multiple healthcare delivery concerns.
To implement this innovative change, surgeons position the biodegradable stent within five centimeters of the bowel cut and pull the extension sleeve through the anus to establish fecal diversion, keeping the surgical site clear of contaminants.
"We're moving away from the complications of traditional stoma formation, establishing normal bowel function and improving recovery outcomes for patients," said the authors. The technique is also hailed for its potential to aid the restoration of anal function sooner, helping to avoid issues related to strictures at the surgical site.
The surgeries were carried out at the General Surgery Department of the Second Affiliated Hospital of Army Medical University and were initiated to explore the practicality of this approach. Patients reported higher comfort levels post-surgery and fewer complications than anticipated. Average operation times clocked at roughly 252.5 minutes, with hospital stays averaging around 15.8 days.
Follow-ups indicated successful elimination of complications typically associated with this kind of surgery. The findings are set to be part of forthcoming multicenter studies as additional data emerges on the viability of this novel technique.
This research not only sets the stage for future surgical standards but also highlights the evolution of surgical techniques, pushing for advancements aimed at enhancing patient care, lowering risk, and ensuring healthier outcomes post-surgery.