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. 2021 Feb;35(2):826-836.
doi: 10.1007/s00464-020-07454-2. Epub 2020 Feb 18.

Transanal total mesorectal excision: the Slagelse experience 2013-2019

Sharaf Karim Perdawood  1 , Jens Kroeigaard  2 , Marianne Eriksen  2 , Pauli Mortensen  2
Affiliations

Transanal total mesorectal excision: the Slagelse experience 2013-2019

Sharaf Karim Perdawood et al. Surg Endosc. 2021 Feb.

Abstract

Objective: To describe outcomes after transanal total mesorectal excision (TaTME) 5 years from implementation at a large-volume colorectal unit, including local recurrence, distant metastasis, and survival.

Background: Transanal total mesorectal excision (TaTME) is a relatively new procedure for mid- and low-rectal cancer, with well-documented safety and feasibility. However, data on long-term results are limited.

Methods: This study was based on a prospective data collection via a maintained database in a large colorectal unit. The database included patients who underwent TaTME from December 2013 through July 2019. We have updated the database through a review of patient charts, including radiology and pathology reports. Data collection included operative details, intraoperative findings, postoperative complications, pathologic results, and oncologic results.

Results: During the study period, two hundred patients underwent TaTME in the study period (men = 147). The mean BMI was 26.7%, and the mean tumor height from the anal verge was 7.86 cm. Neoadjuvant treatment was given to 22% of patients. Anastomotic leakage occurred in 9.3% of patients, and the overall rate of postoperative complications was 24.5%. The TME specimen was incomplete in 11% of patients, and the CRM was positive in 5.5% of patients. Local recurrence (LR) occurred in seven patients with a follow-up of at least 2 years (4.7%). Distant metastasis (DM) occurred in 12% of patients. The overall survival was 90% and disease-free survival was 81%. The operating time was reduced in the later period of our experience.

Conclusions: This study showed that TaTME is feasible, safe, and had acceptable short-term outcomes and an acceptable rate of LR. The study included, however, one group that was non-randomized, and the follow-up was not long enough for most patients. Studies with longer follow-up data are awaited.

Keywords: Oncologic results; Rectal cancer surgery; TaTME; Total mesorectal excision.

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References

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    1. Perdawood, S.K. and G.A. Al Khefagie, Transanal vs laparoscopic total mesorectal excision for rectal cancer: initial experience from Denmark. Colorectal Dis, 2016. 18(1):51–58.
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