Outcomes of a Single Surgeon-Based Transanal-Total Mesorectal Excision (TATME) for Rectal Cancer

Caycedo‐Marulanda, Antonio; Jiang, Han; Kohtakangas, Erica L.

doi:10.1007/s12029-017-9989-7

Cited by 20 publications

(11 citation statements)

References 23 publications

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“…Lacy et al achieved an average operation time of 166 minutes using two teams, whereas Caycedo-Marulanda, using a one-team approach, averaged 283 minutes. 17 , 40 However, a two-team approach requires more personnel and more surgical equipment, which may be limiting factors in some units.…”

Section: Discussionmentioning

confidence: 99%

Transanal total mesorectal excision for low rectal cancer: a case-matched study comparing TaTME versus standard laparoscopic TME

Rubinkiewicz¹,

Nowakowski²,

Wierdak³

et al. 2018

CMAR

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BackgroundTransanal total mesorectal excision (TaTME) is emerging as a novel alternative to laparoscopic total mesorectal excision (LaTME). The aim of this study was to compare clinical and pathological results from these two techniques in patients undergoing rectal resections because of low rectal cancer.Materials and methodsThirty-five patients undergoing TaTME were matched with 35 patients operated on using LaTME. Composite primary endpoint (complete TME, negative circumferential resection margin [pCRM], and distal resection margin [pDRM]) was used to assess pathological quality specimens. Secondary outcomes included operative and postoperative parameters (operative time, total blood loss, postoperative morbidity, length of stay, 30-day mortality).ResultsComposite primary endpoint was achieved by 85% of subjects in the TaTME group and 82% of subjects in the LaTME group (P=0.66). Mean pCRM was 1.1±1.29 vs 0.99±0.78 mm (P=0.25). Distal pDRM was 1.57±0.92 and 1.98±1.22 cm (P=0.15). In the TaTME and LaTME groups, respectively, complete mesorectal excision was achieved in 89% and 83% of subjects, while excision was nearly complete for the remaining 11% and 17% (P=0.23).ConclusionTaTME appears to be a noninferior alternative to laparoscopic surgery. TaTME allows for quality retrieval of surgical specimens with comparable clinical outcomes with LaTME.

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Section: Discussionmentioning

confidence: 99%

Transanal total mesorectal excision for low rectal cancer: a case-matched study comparing TaTME versus standard laparoscopic TME

Rubinkiewicz¹,

Nowakowski²,

Wierdak³

et al. 2018

CMAR

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“…Since inception in 2010, this 'bottom up' approach, in which the resection incorporates procedures through both an abdominal and transanal approach, has proven safe and feasible, with theoretical advantages of access and visualisation in the most challenging portion of a proctectomy, which could make this technique the gold standard for low rectal cancer resection [73][74][75] . Many publications have demonstrated its safety, feasibility and short-term oncological acceptability [74][75][76][77][78][79][80][81] . An international registry, controlled trials and standardised training programs are underway for further outcomes and safe expansion of this technique [82][83][84] .…”

Section: [H1] Neoadjuvant Treatmentmentioning

confidence: 99%

The multidisciplinary management of rectal cancer

Keller

Berho

Perez³

et al. 2020

Nat Rev Gastroenterol Hepatol

222

153

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 As rectal cancer treatment becomes more precise, high-resolution imaging techniques have been established to identify important tumour characteristics that help guide management.  High-resolution magnetic resonance imaging scans are increasingly dictating treatment strategies by providing predictive and prognostic information related to the tumour, and are a standard part of the patient investigation pathway.  Surgical management depends on patient and tumour factors with an aim to optimise function and survival with the lowest risk of recurrence.  Multiple approaches are currently available for resection, including radical surgery involving excision of the rectum and associated mesentery and organsparing techniques involving local excision of the lesion or deferring surgery altogether.  The pathological assessment of the resected rectal cancer specimen provides a level of quality control ensuring that surgical principles have been adhered to and that the surgery was performed in an optimal oncological manner.  Multidisciplinary team presentation of imaging data, evidence-based oncological, surgical and functional recommendations, in addition to pathological assessment of surgical quality, is an essential part of formalised cancer care.

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“…Since these early reports, numerous series have described the safety and feasibility of taTME even in challenging patients. The theoretical advantages of access and visualization have established this technique as not only a credible alternative to more traditional approaches which has the potential to provide optimal outcomes for oncologic resection of low rectal cancers[ 81 - 91 ].…”

Section: Introductionmentioning

confidence: 99%

“…Safety: The safety and feasibility of TaTME for short and midterm outcomes has been extensively described[ 80 , 89 , 91 , 113 - 115 ]. A report from the TaTME International Registry reported postoperative morbidity, anastomotic leakage and mortality rates of 32.6%, 6.7% and 2.6%, respectively[ 83 ].…”

Section: Introductionmentioning

confidence: 99%

Evolution of transanal total mesorectal excision for rectal cancer: From top to bottom

Emile

Lacy

Keller

et al. 2018

WJGS

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The gold standard for curative treatment of locally advanced rectal cancer involves radical resection with a total mesorectal excision (TME). TME is the most effective treatment strategy to reduce local recurrence and improve survival outcomes regardless of the surgical platform used. However, there are associated morbidities, functional consequences, and quality of life (QoL) issues associated with TME; these risks must be considered during the modern-day multidisciplinary treatment for rectal cancer. This has led to the development of new surgical techniques to improve patient, oncologic, and QoL outcomes. In this work, we review the evolution of TME to the transanal total mesorectal excision (TaTME) through more traditional minimally invasive platforms. The review the development, safety and feasibility, proposed benefits and risks of the procedure, implementation and education models, and future direction for research and implementation of the TaTME in colorectal surgery. While satisfactory short-term results have been reported, the procedure is in its infancy, and long term outcomes and definitive results from controlled trials are pending. As evidence for safety and feasibility accumulates, structured training programs to standardize teaching, training, and safe expansion will aid the safe spread of the TaTME.

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Outcomes of a Single Surgeon-Based Transanal-Total Mesorectal Excision (TATME) for Rectal Cancer

Cited by 20 publications

References 23 publications

Transanal total mesorectal excision for low rectal cancer: a case-matched study comparing TaTME versus standard laparoscopic TME

Transanal total mesorectal excision for low rectal cancer: a case-matched study comparing TaTME versus standard laparoscopic TME

The multidisciplinary management of rectal cancer

Evolution of transanal total mesorectal excision for rectal cancer: From top to bottom

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