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Review
. 2019 Jan 29;3(1):1-9.
doi: 10.23922/jarc.2018-030. eCollection 2019.

Transanal TME: new standard or fad?

Suguru Hasegawa  1 , Yoichiro Yoshida  1 , Mitsuaki Morimoto  1 , Daibo Kojima  1 , Akira Komono  1 , Naoya Aisu  1 , Hirotaka Taketomi  1 , Hideki Nagano  1 , Yoshiko Matsumoto  1 , Taro Munechika  1 , Ryuji Kajitani  1
Affiliations
Review

Transanal TME: new standard or fad?

Suguru Hasegawa et al. J Anus Rectum Colon. .

Abstract

Transanal total mesorectal excision (taTME) has been developed to overcome the difficulty of laparoscopic dissection and transection in the deep pelvis. TaTME has several clinical benefits over laparoscopic surgery, such as better exposure of the distal rectum and direct determination of distal resection margin. Although evidence demonstrating the true benefits of taTME over laparoscopic TME (LapTME) is still insufficient, accumulating data have revealed that, as compared with LapTME, taTME is associated with shorter operative time and a lower conversion rate without jeopardizing other short-term outcomes. However, taTME is a technically demanding procedure with specific complications such as urethral injury, and so sufficient experience of LapTME and step-by-step acquisition of the skills needed for this procedure are requisite. The role of transanal endoscopic surgery is expected to change, along with the recent progress in the treatment of rectal cancer, such as robotic surgery and the watch-and-wait strategy. Optimization of treatment will be needed in the future in terms not only of oncological but also of functional outcomes.

Keywords: laparoscope; rectal cancer; surgery; transanal TME.

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Conflict of interest statement

Conflicts of Interest There are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Operations performed using transanal endoscopic approach. a) Local excision (also referred to as transanal minimally-invasive surgery “TAMIS”). b) Intersphincteric resection (ISR) / total mesorectal excision (TME). c) Abdominoperineal resection (APR) (also referred to as “transperineal” APR).
Figure 2.
Figure 2.
Example of set up of operative room.
See this image and copyright information in PMC

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