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Short-term outcomes after transanal and laparoscopic total mesorectal excision for rectal cancer

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Abstract

Background

Transanal total mesorectal excision (taTME) has potential benefits of better visual control, especially in male patients with a high body mass index and low rectal cancer. However, this method has not yet been validated in clinical trials. The aim of this study was to compare the short-term outcomes of transanal and laparoscopic (lap) TME.

Methods

From October 2013 to January 2015, consecutive patients undergoing transanal or laparoscopic TME for biopsy-proven mrT1-4aN0-2M0 rectal cancer were included in a prospective database. Patients with Eastern Cooperative Oncology Group performance status 2 and higher and patients undergoing partial mesorectal excision were excluded. This analysis focused on short-term surgical outcomes.

Results

From October 2013 to January 2015, 22 taTME procedures and 23 laparoscopic TME procedures were performed. Patient characteristics were comparable between groups, but more patients in the taTME group underwent neoadjuvant (chemo) radiotherapy (87 vs. 48 %, p = 0.006). Median operative time was 320 min in the taTME group and 305 min in the lapTME group. There was one conversion in each group, but the transanal procedure was converted to laparoscopic resection. Transanal specimen extraction was performed in 86 versus 48 % patients in taTME and lapTME groups accordingly (p = 0.021). There was no post-operative mortality and post-operative morbidity in the taTME and lapTME groups was similar (27 vs. 26 %). One patient in the taTME group had positive circumferential resection margins. Oncologic results from resected specimens were comparable.

Conclusions

Our initial experience demonstrates comparable short-term results for taTME and lap TME. Further investigation is necessary to assess long-term functional and oncologic outcomes.

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Authors and Affiliations

  1. Department of Oncoproctology, Russian N. N. Blokhin Cancer Research Center, Moscow, Russia

    A. O. Rasulov, Z. Z. Mamedli, S. S. Gordeyev & H. E. Dzhumabaev

  2. Department of Pathology, Russian N. N. Blokhin Cancer Research Center, Moscow, Russia

    N. A. Kozlov

Authors
  1. A. O. Rasulov
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  2. Z. Z. Mamedli
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  3. S. S. Gordeyev
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  4. N. A. Kozlov
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  5. H. E. Dzhumabaev
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Corresponding author

Correspondence to S. S. Gordeyev.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the local ethics committee (Russian N. N. Blokhin Cancer Research Center).

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All patients signed an informed consent to proposed treatment.

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Rasulov, A.O., Mamedli, Z.Z., Gordeyev, S.S. et al. Short-term outcomes after transanal and laparoscopic total mesorectal excision for rectal cancer. Tech Coloproctol 20, 227–234 (2016). https://doi.org/10.1007/s10151-015-1421-3

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  • DOI: https://doi.org/10.1007/s10151-015-1421-3

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