Our Summary

This research paper discusses a surgical method called Near-TME that’s used during a proctectomy (surgical removal of the rectum), specifically in patients with ulcerative colitis. The Near-TME technique combines the benefits of two existing surgical methods and decreases the risk of damage to the pelvic autonomic nerves. It also reduces the amount of leftover tissue from the mesorectum (the fatty tissue that surrounds the rectum). The paper aims to establish the standard for performing Near-TME in women, as the key anatomical landmarks in the surgery differ between men and women. The technique is demonstrated via illustrations and a real-life case. The paper emphasizes that this technique should be performed by experienced surgeons with extensive knowledge of surgical anatomy and inflammatory bowel disease surgery.

FAQs

  1. What is the Near-TME technique used in proctectomy surgeries and how does it benefit the patient?
  2. Does the Near-TME technique in proctectomy surgeries differ between men and women?
  3. What qualifications should a surgeon have in order to effectively perform a Near-TME technique during a proctectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about proctectomy is to discuss with their surgeon the possibility of using the Near-TME technique, especially if they have ulcerative colitis. This technique can help reduce the risk of nerve damage and ensure a more precise removal of the rectum, leading to better outcomes post-surgery. It’s important to choose a surgeon who is experienced in performing this technique and has a good understanding of the patient’s specific condition.

Suitable For

Patients who are typically recommended for a proctectomy include those with severe cases of ulcerative colitis, Crohn’s disease, rectal cancer, or other conditions that affect the rectum and require surgical removal. These patients may have failed to respond to conservative treatments or medications, or may have complications such as severe inflammation, strictures, fistulas, or tumors in the rectum. Additionally, patients with a family history of colorectal cancer or a genetic predisposition to developing colorectal diseases may also be recommended for a proctectomy as a preventative measure. It is important for patients to consult with their healthcare provider to determine if a proctectomy is the best treatment option for their specific condition.

Timeline

Before the proctectomy:

  • Patient is evaluated by a surgeon to determine the need for a proctectomy, usually due to conditions such as ulcerative colitis.
  • Patient undergoes preoperative testing and preparation for surgery.
  • Surgical team discusses the risks and benefits of the procedure with the patient.
  • Patient may receive counseling and support to prepare mentally and emotionally for the surgery.

After the proctectomy:

  • Patient undergoes the Near-TME technique during the proctectomy surgery.
  • Surgical team ensures that the pelvic autonomic nerves are preserved and that the mesorectum is adequately removed.
  • Patient is monitored closely in the postoperative period for any complications.
  • Patient undergoes recovery and rehabilitation, which may involve physical therapy and dietary changes.
  • Patient may require a temporary or permanent colostomy depending on the extent of the surgery.
  • Patient follows up with the surgical team for follow-up appointments and monitoring of their condition.

What to Ask Your Doctor

  1. What is a proctectomy and why is it necessary for my condition?
  2. What are the potential risks and complications associated with a proctectomy?
  3. How does the Near-TME technique differ from other surgical methods for proctectomy?
  4. How experienced are you in performing the Near-TME technique?
  5. What is the recovery process like after a proctectomy with the Near-TME technique?
  6. Will I need any additional treatments or therapies after the surgery?
  7. How will this surgery affect my quality of life in the long term?
  8. Are there any alternative treatment options to consider before proceeding with a proctectomy?
  9. What follow-up care will be necessary after the surgery?
  10. Can you provide me with any resources or information to help me better understand the procedure and what to expect?

Reference

Authors: Ferrer-Inaebnit E, Jeri McFarlene S, García-Granero García-Fuster A, González Argenté X. Journal: Cir Esp (Engl Ed). 2024 Jan;102(1):32-39. doi: 10.1016/j.cireng.2023.11.005. Epub 2023 Nov 11. PMID: 37956717