Related Experiment Video
Updated: May 15, 2025
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Transanal total mesorectal excision for locally advanced rectal cancer following neoadjuvant chemoradiotherapy
Takeru Matsuda1,2, Kimihiro Yamashita3, Hiroshi Hasegawa3
1Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. takerumatsuda@nifty.com.
Purpose:
To examine the clinical impact of transanal total mesorectal excision (TaTME) for locally advanced rectal cancer after neoadjuvant chemoradiotherapy (NACRT).
Methods:
This retrospective study included 91 patients undergoing surgery for rectal cancer after NACRT between 2011 and 2022. Among them, 24, 22, and 45 patients underwent open (Open), conventional laparoscopic (Lap), and TaTME surgeries, respectively. We compared their clinical outcomes.
Results:
Operative time, blood loss, transfusion, morbidity, and hospital stay were significantly lower in the TaTME group than in the Open or Lap groups. The multivariate regression analyses identified only the TaTME approach as a significant factor for reducing morbidity. Both 3 yrear relapse-free survival (RFS) and local recurrence-free survival (LRFS) were significantly better in the TaTME group than in the Open or Lap groups (3 yr RFS: 94.7%, 80.4%, and 66.7%, and 3 yr LRFS: 100%, 90.5%, and 82.2% for the TaTME, Lap, and Open groups, respectively). Multivariate analyses of potential risk factors for recurrence identified body mass index, combined resection, and pathological stage, but not the TaTME approach, as significant predictors of recurrence.
Conclusion:
TaTME reduced morbidity significantly in patients with locally advanced rectal cancer undergoing NACRT, compared with open or laparoscopic surgery.
