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The transanal approach for rectal cancer (TaTME) and combined dissection by a transabdominal and transanal team (Cecil approach) has emerged as the next step in rectal cancer surgery. TaTME (the Cecil approach) aims to solve some problems that occurred in the previous TME, such as exposure of the peripheral mid-lower rectal space, judging the distal cutting margin, carrying out a completely minimal invasive operation, overcoming the lack of visibility in the small pelvis, and theoretically improving the rate of radical resections

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A 26-year-old female patient with a BMI of 18.8 kg/m2 and a previous clinical history of abdominal pain and rectal bleeding for 6 months so a colonoscopy was performed, objectifying a rectal neoplasm 6 cm from the anal verge. The biopsy showed a well differentiated adenocarcinoma. The study was completed with a CT scan that did not show distant metastasis and a blood test with a CEA of 0.8. An MRI was also performed which showed a T3aN1M0 mid-rectal cancer and the functional study was normal. It was decided to perform neoadjuvant therapy with QT / RDT. The MRI control after treatment showed a T3N0M0 stage. Consequently, it was proposed to perform a LAR + TaTME (Cecil approach)

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Dr. Antonio M. de Lacy MD, PhD, FACS (Hon), FASCRS (Hon), IQL Director, Department of Surgery, Hospital Quirón Barcelona, Hospital Ruber Internacional Madrid and Clínica Rotger Palma de Mallorca; AIS Founder and President, Spain General Surgery
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