Transanal Total Mesorectal Excision

Penna, Marta; Hompes, Roel; Arnold, Steve; Wynn, Greg; Austin, Ralph; Warusavitarne, Janindra; Moran, Brendan; Hanna, George B.; Mortensen, Neil; Tekkis, Paris

doi:10.1097/sla.0000000000001948

Cited by 383 publications

(143 citation statements)

References 24 publications

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“…As TaTME starts at the most distal part of the TME plane, theoretically it will result in a complete TME specimen and improve the quality of surgery. Other groups confirmed the data of Lacy and Adelsdorfer [10] and showed safe implementation [11–15]. …”

supporting

confidence: 69%

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Residual mesorectum on postoperative magnetic resonance imaging following transanal total mesorectal excision (TaTME) and laparoscopic total mesorectal excision (LapTME) in rectal cancer

et al. 2018

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supporting

confidence: 69%

“…The international registry recently reported on the first 720 cases and showed acceptable short-term patient outcomes [15]. Data from the most experienced centre even suggest short-term benefits [23].…”

Section: Discussionmentioning

confidence: 99%

Residual mesorectum on postoperative magnetic resonance imaging following transanal total mesorectal excision (TaTME) and laparoscopic total mesorectal excision (LapTME) in rectal cancer

et al. 2018

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“…To date the largest single series is of 140 patients[64] and although the results were of limited follow-up and did not include an evaluation of functional outcome, there were no conversions, operative complications were comparable to the “top-down” laparoscopic and 97% of the resected specimens macroscopically had complete TME. Still there must be a word of caution as the results of the international registry of the first 720 procedures from 66 registered units in 23 countries were recently published showing that conversion occurred in 9.1%, intact TME specimens was achieved in 85% and postoperative mortality and morbidity occurred in 0.5% and 32.6% respectively[88]. …”

Section: Minimally Invasive Surgerymentioning

confidence: 99%

Recent advances in the management of rectal cancer: No surgery, minimal surgery or minimally invasive surgery

Plummer

Leake

Albert

2017

WJGS

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Over the last decade, with the acceptance of the need for improvements in the outcome of patients affected with rectal cancer, there has been a significant increase in the literature regarding treatment options available to patients affected by this disease. That treatment related decisions should be made at a high volume multidisciplinary tumor board, after pre-operative rectal magnetic resonance imaging and the importance of total mesorectal excision (TME) are accepted standard of care. More controversial is the emerging role for watchful waiting rather than radical surgery in complete pathologic responders, which may be appropriate in 20% of patients. Patients with early T1 rectal cancers and favorable pathologic features can be cured with local excision only, with transanal minimal invasive surgery (TAMIS) because of its versatility and almost universal availability of the necessary equipment and skillset in the average laparoscopic surgeon, emerging as the leading option. Recent trials have raised concerns about the oncologic outcomes of the standard “top-down” TME hence transanal TME (TaTME “bottom-up”) approach has gained popularity as an alternative. The challenges are many, with a dearth of evidence of the oncologic superiority in the long-term for any given option. However, this review highlights recent advances in the role of chemoradiation only for complete pathologic responders, TAMIS for highly selected early rectal cancer patients and TaTME as options to improve cure rates whilst maintaining quality of life in these patients, while we await the results of further definitive trials being currently conducted.

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“…The cumulative morbidity rate is reportedly 6.3% in male patients [3][4][5][6][7]. In the international TaTME registry, the rate of urethral injuries in males was 1% (5/489) [8]. However, a voluntary registry could underestimate the risk.…”

Section: Introductionmentioning

confidence: 99%

Urethral injury in body donor TaTME training

et al. 2017

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Transanal Total Mesorectal Excision

Abstract: TaTME appears to be an oncologically safe and effective technique for distal mesorectal dissection with acceptable short-term patient outcomes and good specimen quality. Ongoing structured training and the upcoming randomized controlled trials are needed to assess the technique further.

Cited by 383 publications

References 24 publications

Residual mesorectum on postoperative magnetic resonance imaging following transanal total mesorectal excision (TaTME) and laparoscopic total mesorectal excision (LapTME) in rectal cancer

Residual mesorectum on postoperative magnetic resonance imaging following transanal total mesorectal excision (TaTME) and laparoscopic total mesorectal excision (LapTME) in rectal cancer

Recent advances in the management of rectal cancer: No surgery, minimal surgery or minimally invasive surgery

Urethral injury in body donor TaTME training

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