Transanal total mesorectal excision--a systematic review.

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Total mesorectal excision (TME) is the standard surgical treatment for mid and low rectal cancer.
• Transanal TME (TaTME) is an emerging technique addressing challenges in pelvic dissection.
• Existing surgical approaches include open, laparoscopic, and robotic methods.

Purpose of the Study:

• To systematically evaluate the existing literature on the transanal total mesorectal excision (TaTME) procedure.
• To assess the feasibility, preliminary outcomes, and complications associated with TaTME.
• To identify areas requiring further research in TaTME.

Main Methods:

• Systematic literature search conducted in PubMed and Embase databases.
• Inclusion of all publications on TaTME, excluding review articles.
• Assessment of studies by both authors.

Main Results:

• 29 studies comprising 336 patients were included, predominantly case reports and series.
• Evidence quality is low, reflecting initial surgical experiences.
• Preliminary results are encouraging for mid and low rectal tumors, particularly with bulky mesorectum.
• Urethral injury is the most serious complication; oncological outcomes are acceptable with short follow-up.

Conclusions:

• Transanal TME (TaTME) is a feasible surgical option for mid and low rectal cancers.
• Long-term data on functional results, recurrence, and survival are needed.
• Further studies are required to compare TaTME with standard laparoscopic or robotic TME.