Transanal rectal resection: an initial experience of 20 cases

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Oncology

Background:

• Low anterior resection (LAR) poses surgical challenges for distal rectal tumors.
• Transanal total mesorectal excision (taTME) offers a potential solution to these difficulties.

Purpose of the Study:

• To report the initial experience and outcomes of the transanal total mesorectal excision (taTME) technique.
• To evaluate the safety and feasibility of taTME for low rectal pathologies.

Main Methods:

• A prospective database was maintained for 20 selected patients undergoing transanal rectal resection between June 2013 and September 2014.
• All rectal cancer cases were reviewed in a multidisciplinary team meeting.
• Data included operative details, postoperative complications, and oncological outcomes.

Main Results:

• Seventeen of 20 patients had rectal cancer, with tumors located a median of 2 cm from the anorectal junction.
• The minimally invasive approach included 16 LARs, with 94.1% intact TME specimens and an R1 rate of 5.9%.
• Six postoperative complications occurred, including two Clavien-Dindo Grade IIIb events; median length of stay was 7 days.

Conclusions:

• Transanal total mesorectal excision (taTME) demonstrated safety in this small patient cohort.
• The technique is particularly beneficial for patients with narrow, irradiated pelves and distal rectal tumors.
• Good outcomes warrant further randomized studies and international registry participation.