Transanal Total Mesorectal Excision for Treatment of Carcinoma in the Middle or Lower Third Rectum: the Technical Feasibility of the Procedure, Pathological Results, and Clinical Outcome
We are trying to illustrate operative, short-term, and pathological outcomes of transanal total mesorectal excision (TaTME) as a surgical procedure for patients who are suffering cancer in the lower or middle rectum. This study included 25 consecutive patients who underwent TaTME for the mid and low cancer rectum. The primary outcome measures included frequency of postoperative (PO) bleeding, leakage, ileus, days to regain bowel function, days for Foley’s removal, and erectile function. The secondary outcome measures included operation time, status of resection margins, number, the quality of TME, and duration PO hospital stay. No recorded intraoperative complications. The mean hospital stay was 6.9 ± 2.6 days. The mean duration need for urinary catheter removal and flatus passage were 2.4 ± 2.1 and 1.5 + 0.9 days, respectively. The mean IPSS was returned to normal 12 months after surgery. The mean distal margin distance was 1.9 ± 1.1. Circumferential margin distance was > 1 mm in 23 (92%) patients. The mesorectum was complete in 22 (88%) patients. The survival rate was 88% over 3 years. TaTME could be considered as a safe, feasible, and effective surgical modality for patients who had mid and lower rectal tumors with an excellent pathological outcome.
KeywordsCA rectum Transanal TME Pathological outcome
Concept and design: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD
Manuscript preparation: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD
Data and statistical analysis: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD
Manuscript editing: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD
Literature search: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD
Manuscript review: Ashraf MA, Ahmed MZ, Mohamed T, Shaimaa KD
Compliance with Ethical Standards
Conflicts of Interest
The authors declare that they have no conflicts of interest.
Patient informed consents were obtained before the operation, as with all procedures.
This data collection was approved by the Ethical Committee of our hospital.
- 1.Shanna A, Harvey J, Charles S, Leona A, Sree H, Nikhil H, Michael H (2015) Anorectal cancer: critical anatomic and staging distinctions that affect use of radiation. Ther Radio 35(7):2090–2107Google Scholar
- 9.Daniel L, Freddy P, Steffen F, Anne J, Christine S, Constant J, Elizabeth V (2010) Factors predicting the quality of total mesorectal excision for rectal cancer. Ann Surg 252(6)Google Scholar
- 11.Autschbach F (2005) The pathological assessment of total mesorectal excision: what are the relevant resection margins? Inst Path Heid Univ Im Neu Feld 220/221:69120Google Scholar
- 12.Harmeet K, Haesun C, Nancy Y, Gaiane M, Corey T, Ping H et al (2012) MR imaging for preoperative evaluation of primary rectal cancer: practical considerations. RadiogGraph 32(2)Google Scholar
- 13.Hacking C, Yang N (2018) Rectal cancer (staging). RadiopaediaGoogle Scholar
- 15.Stevenson A, Solomon M, Lumley J, Hewett P, Clouston A, Gebski V, Davies L, Wilson K, Hague W, Simes J, ALaCaRT Investigators (2015) Effect of laparoscopic-assisted resection vs open resection on pathological outcomes in rectal cancer: the ALaCaRT randomized clinical trial. JAMA 314(13):1356–1363CrossRefPubMedGoogle Scholar
- 22.Bin M, Peng G, Yongxi S, Cong Z, Changwang Z, Longyi W, Hongpeng L, Zhenning W (2016) Transanal total mesorectal excision (taTME) for rectal cancer: a systematic review and meta-analysis of oncological and perioperative outcomes compared with laparoscopic total mesorectal excision. BMC Cancer J 7. https://doi.org/10.1186/s12885-016-2428-5
- 23.Chen C, Lai Y, Jiang J, Chu C, Huang I, Chen W et al (2015) Transanal total mesorectal excision versus laparoscopic surgery for rectal cancer receiving neoadjuvant chemoradiation: a matched case-control study. Ann Surg OncolGoogle Scholar