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Updated: Jan 27, 2026
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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
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[Transanal total mesorectal excision-a critical appraisal]
C Holmer1, S Benz2, S Fichtner-Feigl3
1Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Hindenburgdamm 30, 12200, Berlin, Deutschland.
Summary
Transanal total mesorectal excision (taTME) shows no superiority over laparoscopic TME for rectal cancer surgery. Careful patient selection and surgeon training are crucial due to potential risks and complications.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Total mesorectal excision (TME) is the standard for rectal cancer.
- Transanal TME (taTME) emerged to improve outcomes but lacks extensive evidence.
- taTME is increasingly adopted despite limited comparative data.
Purpose of the Study:
- To compare transanal TME (taTME) with laparoscopic TME (lapTME) for rectal cancer surgery.
- To evaluate taTME's efficacy and safety against the current standard of care.
- To assess oncological and functional outcomes of taTME.
Main Methods:
- Systematic literature search of PubMed and Medline databases.
- Inclusion of studies on transanal total mesorectal excision (taTME) and TAMIS.
- Reference list analysis for additional relevant publications.
Main Results:
- 16 studies involving 3782 patients were analyzed.
- taTME did not demonstrate superior rates of complete mesorectal excision.
- No significant advantage shown for complication, functional, or oncological outcomes; risks of incorrect dissection noted.
Conclusions:
- Current evidence does not support taTME's superiority over conventional anterior lapTME.
- taTME presents potential benefits but carries significant risks.
- Use outside trials requires careful patient selection, informed consent, and extensive surgeon training.
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