[Transanal total mesorectal excision and organ function preservation].

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Transanal total mesorectal excision (taTME) utilizes endoscopic assistance and pelvic pneumoperitoneum.
• The transanal minimally invasive surgery (TAMIS) platform may reduce internal anal sphincter injury.

Purpose of the Study:

• To evaluate the oncological safety and nerve protection offered by taTME.
• To compare functional outcomes of taTME with transabdominal TME.

Main Methods:

• Review of current data comparing taTME and transabdominal TME.
• Analysis of factors influencing early postoperative anal function.
• Guidance for pelvic nerve and organ function preservation during taTME.

Main Results:

• taTME shows similar postoperative anal, urinary, and sexual function compared to transabdominal TME.
• Early anal function impairment may relate to the transanal approach, single port, and learning curve, but improves over time.
• Nerve protection during taTME requires familiarity with pelvic anatomy and careful dissection.

Conclusions:

• taTME is distinct from NOTES, prioritizing oncological safety and nerve protection.
• Combining transanal and transabdominal approaches can enhance surgical quality and organ function preservation.