The effectiveness of double team for transanal total mesorectal excision in treatment of mid-low rectal cancer

Abstract

Introduction: Transanal total mesorectal (TaTME) is an emerging surgical technique for mid-low rectal cancer. This study investigated the double-team TaTME on the short-term morbidity, quality of surgical specimens, and functional and oncologic outcomes by comparing them with the single-team TaTME. Methods: We analyzed the surgical results of 72 patients (n = 40 double-team TaTME, n = 32 single-team TaTME) with mid-low rectal cancer who treated for mid-low rectal cancer with single-team TaTME or double-team TaTME. Results: The operative time was significantly shorter with a double-team TaTME (180 ± 45 min) than with a single-team TaTME (230 ± 55 min). Also, there were no intraoperative events recorded in both groups. The rate of pre-sacral abscesses complications (grade III) in the double-team (0%) was significantly lower than in the single-team group (3, 9.4%). The proportions of TME grade I, TME grade II, and TME grade III were not significantly different between the single-team and double-team groups. A positive circumferential resection margin (CRM) was not significantly different between the double-team groups (2, 5.0%) and the single-team (3, 9.3%). The mean low anterior resection syndrome (LARS) scores were lower in the double-team group (27 ± 4.5) than in the single-team group (29 ± 3.8) (p = 0.048). Simultaneously, the disease-free survival (DFS) rate was not significantly different between the two groups. Conclusion: The double-team TaTME in treatment of mid-low rectal cancer is effective with the shortness of operative time, the lower rate of the postoperative pre-sacral abscess, and LARS scores, while this method guaranteed the quality of mesorectal specimens and the DFS rate.