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Clin Colon Rectal Surg 2022; 35(02): 141-145
DOI: 10.1055/s-0041-1742115
Review Article

Limitations and Concerns with Transanal Total Mesorectal Excision for Rectal Cancer

M. Vannijvel
1   Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium
,
Albert M. Wolthuis
1   Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium
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Abstract

Transanal total mesorectal excision (TaTME) was developed to overcome the technical challenges of a minimally invasive (ultra-) low anterior resection. This new technique has recently come under careful scrutiny as technical pitfalls were reported, in specific relation to the transanal approach. Patients are at risk for urologic lesions. Moreover, carbon dioxide embolism is a rare but potentially life-threatening complication. The benefit of TaTME from an oncological point of view has neither been clarified. Hypothetically, better visualization of the lower rectum could lead to better dissection and total mesorectal excision (TME) specimens, resulting in better oncologic results. Up until now, retrospective multicenter reports seem to show that short-term oncologic results are not inferior after TaTME as compared with after laparoscopic TME. Alarming reports have however been published from Norway suggesting a high incidence and particular multifocal pattern of early local recurrence. In this article, a balanced overview is given of the most important technical pitfalls and oncological concerns arising with this new procedure.

Keywords

rectal cancer - transanal total mesorectal excision - complications


Publikationsverlauf

Artikel online veröffentlicht:
28. Februar 2022

© 2022. Thieme. All rights reserved.

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