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[PDF: Members Only] J.Jpn. Surg. Soc.. 121(3): 315-320, 2020
Feature topic
TRANSANAL TOTAL MESORECTAL EXCISION FOR RECTAL CANCER
Laparoscopic surgery is becoming more common in rectal cancer surgery. However, in laparoscopic total mesorectal excision (LapTME), some difficulties are encountered in laparoscopic dissection and transection in the deep pelvis, especially for difficult cases such as narrow male pelvis, obese patients, or bulky tumors. Transanal TME (TaTME) has been developed to overcome such problems. TaTME has several clinical benefits over laparoscopic surgery such as better exposure of the distal rectum and direct determination of the distal resection margin. Although high-quality evidence demonstrating the true benefits of TaTME is still insufficient, accumulating data have revealed that TaTME is associated with a lower conversion rate and circumferential resection margin or distal margin positive rate without jeopardizing other short-term outcomes as compared with LapTME. However, TaTME is a technically demanding procedure with specific potential complications such as urethral injury, purse-string rupture, and carbon dioxide embolism. Therefore, step-by-step acquisition of the skills needed for this procedure is necessary for its safe performance.
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