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Inicio Cirugía Española (English Edition) Female near-TME: standardization of proctectomy in women with ulcerative colitis
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Vol. 102. Issue 1.
Pages 32-39 (January 2024)
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Vol. 102. Issue 1.
Pages 32-39 (January 2024)
Innovation in surgical technique
Female near-TME: standardization of proctectomy in women with ulcerative colitis
Estandarización de la proctectomia en mujeres con colitis ulcerosa
E. Ferrer-Inaebnita, S. Jeri McFarlenea,b,c, A. García-Granero García-Fustera,b,c,
Corresponding author
alvarogggf@hotmail.com

Corresponding author.
, X. González Argentéa,c
a Unidad de Coloproctología, Servicio Cirugía General y Aparato Digestivo, Hospital Universitario Son Espases, Palma de Mallorca, Spain
b Instituto de Investigación Sanitaria Illes Balears (IdISBa), Spain
c Profesor del Departamento de Anatomía y Embriología Humana, Universidad de Islas Baleares (UIB), Palma de Mallorca, Spain
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Abstract

Traditionally, 2 surgical techniques for proctectomy in ulcerative colitis have been used: total mesorectal excision (TME), and close rectal dissection (CRD). Recently, our research group has proposed the standardization of the Near-TME technique, which unites the advantages of both methods. It decreases the risk of pelvic autonomic nerve injury and reduces the volume of mesorectal remnant. When performing the Near-TME, the anatomical landmarks differ between men and women, especially in the anterolateral hemicircumference. The objective of this paper is to standardize the Near-TME technique in women (Female Near-TME) using characteristic surgical-anatomic landmarks of the female pelvis based on illustrations and a real case treated laparoscopically.

This technique should be carried out by surgeons with experience in inflammatory bowel disease surgery and extensive knowledge of surgical anatomy.

Keywords:
Ulcerative colitis
Near-TME
Proctectomy
Mesorectum
Resumen

Dos técnicas quirúrgicas de proctectomía en colitis ulcerosa han sido empleadas tradicionalmente; la escisión total de mesorrecto (TME) y la disección perirrectal (CRD). Recientemente, el presente grupo de trabajo ha propuesto la estandarización de la técncia Near-TME, la cual reúne las ventajas de éstas dos. Disminuye el riesgo de lesión nerviosa autónoma pélvica y disminuye el volumen de remanente mesorrectal. Las referencias anatómicas a la hora de realizar la Near-TME varían entre el varón y la mujer, sobre todo en la hemicircunferencia anterolateral. El objetivo del presente trabajo es estandarizar la técnica de Near-TME en mujeres (FEMALE NEAR-TME) a partir de landmarks anatomoquirúrgicos característicos de la pelvis femenina a partir de ilustraciones y de un caso real intervenido de forma laparoscópica.

Esta técnica debe ser llevada a cabo por cirujanos con experiencia en cirugía de la enfermedad inflamatoria intestinal y con amplios conocimientos anatomoquirúrgicos.

Palabras clave:
Colitis ulcerosa
Near-TME
Proctectomía
Mesorecto

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