Annals of Coloproctology

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Original Article

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Minimally invasive surgery

Should transanal total mesorectal excision be implemented in medium-sized colorectal unit? technical and oncological outcome: Man-fung Ho, Dennis Chung-Kei Ng, Janet Fung-yee Lee, Simon Siu-man Ng; Ann Coloproctol. 2022;38(3):207-215. Published online July 28, 2021; DOI: https://doi.org/10.3393/ac.2020.00941.0134

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4 Citations

Purpose
This study was performed to evaluate the outcome of implementation of transanal total mesorectal excision (TaTME) for low rectal cancer in a regional hospital and in comparison to laparoscopic (Lap) TME.
Methods
Consecutive patients with low rectal cancer of which the lowest border of the tumour was located beween 1 and 5 cm from the puborectalis who underwent TME at North District Hospital between January 2013 and December 2019 were included. Clinical, operative, and pathologic outcomes were compared between Lap TME and TaTME. The primary end point was complication profile.
Results
Thirty-five patients underwent Lap TME and 45 patients underwent TaTME for low rectal cancer. The conversion rate of the TaTME group was significantly lower than that of the Lap TME group (4.4% vs. 20%, P=0.029), but the operating time was longer (259 minutes vs. 219 minutes, P=0.009). The tumour location was significantly lower in the TaTME group, but the distal resection margins were adequate and not different between both groups. The TaTME group had higher incidence rates of prolonged ileus and urinary tract infection, but the other complications were similar between the two groups. The resection margin positivity rates of the TaTME and Lap TME groups were 2.2% and 5.7%, respectively (P=0.670). At a median follow up of 39 months, no abnormal early recurrence was detected.
Conclusion
It is technically feasible and oncologically safe to perform TaTME in a medium-volume colorectal unit. Patients with difficult pelvic anatomy can benefit by reducing the risk of conversion and margin positivity rate.

Citations

Citations to this article as recorded by

The Korean Rectal Cancer Multidisciplinary Committee Clinical Practice Guidelines for Rectal Cancer version 2.0
Hyo Seon Ryu, Hyun Jung Kim, Dong Hyun Kang, Yoo-Kang Kwak, Han Deok Kwak, Yoon-Hye Kwon, Dalyon Kim, Baek-Hui Kim, Jae Hyun Kim, Ji Hun Kim, Jin Won Kim, Tae Hyung Kim, Hae Young Kim, Soo Min Nam, Gyoung Tae Noh, Jun Woo Bong, Nak Song Sung, Seon Hui Shi
Annals of Coloproctology.2026; 42(1): 4. CrossRef
Transanal versus transabdominal total mesorectal excision for rectal cancer in minimally invasive surgery: meta-analysis
Chun-Kai Liao, Yen-Lin Yu, Ya-Ting Kuo, Yu-Jen Hsu, Yih-Jong Chern, Yueh-Chen Lin, Pao-Shiu Hsieh, Jeng-Fu You, Jy-Ming Chiang
BJS Open.2025;[Epub] CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. CrossRef

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