Outcomes of robotic low anterior resection <i>versus</i> transanal total mesorectal excision for rectal cancer

Buan, Bryan Jun Liang; So, Wei Zheng; Lim, Xiong Chang; Chong, Choon Seng

doi:10.1093/bjsopen/zrab079

Cited by 4 publications

(1 citation statement)

References 28 publications

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“…Several retrospective studies have attempted to demonstrate the efficacies of taTME compared to laparoscopic and/or robotic TME, but convincing results have not yet been obtained (Table 1). 44,[47][48][49][50][51] Even international expert consensus has had difficulty reaching agreement on the indications for or best practice of taTME. 29 Most of the favorable results of taTME have been reported from large referral centers with highly skilled colorectal surgeons.…”

Section: Cost-effectiveness Of Tatmementioning

confidence: 99%

Current status of transanal total mesorectal excision for rectal cancer and the expanding indications of the transanal approach for extended pelvic surgeries

Uehara

Ogura

Murata

et al. 2022

Digestive Endoscopy

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Transanal total mesorectal excision (taTME) has been rapidly accepted as a promising surgical approach to the distal rectum. The benefits include ease of access to the bottom of the deep pelvis linearly over a short distance in order to easily visualize the important anatomy. Furthermore, the distal resection margins can be secured under direct vision. Additionally, a two‐team approach combining taTME with a transabdominal approach could decrease the operative time and conversion rate. Although taTME was expected to become more rapidly popularized worldwide, enthusiasm for it has stalled due to unfamiliar intraoperative complications, a lack of oncologic evidence from randomized trials, and the widespread use of robotic surgery. While international registries have reported favorable short‐ and medium‐term outcomes from taTME, a Norwegian national study reported a high local recurrence rate of 9.5%. The characteristics of the recurrences included rapid, multifocal growth in the pelvis, which was quite different from recurrences following traditional transabdominal TME; thus, the Norwegian Colorectal Cancer Group reached a consensus for a temporary moratorium on the performance of taTME. To ensure acceptable baseline quality and patient safety, taTME should be performed by well‐trained colorectal surgeons. Although the appropriate indications for taTME remain controversial, the transanal approach is extremely important as a means of goal setting in difficult TME cases and as an aid to the transabdominal approach in various types of extended pelvic surgeries. The benefits in transanal lateral lymph node dissection and pelvic exenteration are presented herein.

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