[Transanal total mesorectal excision-Indications, technique and results]

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Total mesorectal excision (TME) is the standard for mid and lower rectal cancer.
• Laparoscopic TME is non-inferior to open surgery.
• Anatomical limitations pose challenges for adequate rectal cancer resection.

Purpose of the Study:

• To describe the transanal TME (TaTME) technique, its applications, and current evidence.
• To provide recommendations for the safe implementation of TaTME.
• To highlight TaTME's potential in complex anatomical regions.

Main Methods:

• Review of current data and literature on TaTME.
• Description of the TaTME surgical procedure.
• Discussion of prospective randomized trials comparing TaTME with conventional techniques.

Main Results:

• TaTME aims to improve oncological resection and neural preservation in difficult cases.
• Current evidence is mainly from retrospective studies.
• Prospective trials are underway to evaluate surgical and oncological outcomes.

Conclusions:

• TaTME is a valuable approach for rectal cancer in anatomically challenging situations.
• Implementation requires specialized centers with high volume and expertise.
• Further evidence from prospective trials is needed to confirm its benefits.