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Transanal total mesorectal excision: 3-year oncological outcomes

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Abstract

Background

Rectal cancer treatment has evolved with the implementation of new surgical techniques. Transanal total mesorectal excision (TaTME) is the most recent approach developed to facilitate pelvic dissection of mid- and distal rectal tumours. The purpose of this study was to analyse the short- and mid-term oncological outcomes of TaTME.

Methods

A study was conducted on patients treated with TaTME for rectal cancer at two colorectal units in Portugal between March 2016 and December 2018. Clinical, pathological and oncological data were retrospectively analysed. Primary endpoints were 3-year overall survival, disease-free survival and local recurrence. Secondary endpoints were clinical and pathological outcomes.

Results

Fifty patients (31 males, [62%], median age 66 years [range 40–85 years]) underwent TaTME, 49 (98%) for malignant and 1 (2%) for benign disease. There were no cases of conversion, 49 (98%) patients had complete or near-complete mesorectum, all the resections were R0 with adequate distal and circumferential margins. With a median follow-up of 36 months, there were 2 cases (4%) of local recurrence and 3-year estimated overall survival and disease-free survival were 90% and 79%, respectively.

Conclusions

TaTME can provide safe mid-term oncological outcomes, similar to what has been published for classic and laparoscopic TME. Our results also show how demanding this novel approach can be and the consequent need for audited data and standardized implementation.

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Availability of data and material

The datasets analysed during the current study are available in the Hospital Beatriz Ângelo e Hospital da Luz informatics hospital database (Soarien), obtainable from the corresponding author on reasonable request.

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Funding

This work did not receive funding.

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Authors and Affiliations

  1. Surgical Department of Hospital Beatriz Ângelo, Loures, Portugal

    S. Ourô, D. Albergaria, M. P. Ferreira, B. Costeira & R. Maio

  2. NOVA Medical School, Lisbon, Portugal

    S. Ourô, D. Albergaria & R. Maio

  3. Surgical Department of Hospital da Luz, Lisbon, Portugal

    P. Roquete & D. Ferreira

  4. Surgical Department, Hospital Beatriz Ângelo, Avenida Carlos Teixeira 514, Loures, Portugal

    S. Ourô

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  1. S. Ourô
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Contributions

SO: study conception and design, acquisition, analysis and interpretation of the data, drafting of the article, critical revision of the article for important intellectual content, final approval of the article. BC: analysis and interpretation of the data, critical revision of the article for important intellectual content final approval of the article. MPF: analysis and interpretation of the data, critical revision of the article for important intellectual content, final approval of the article. DA: analysis and interpretation of the data, critical revision of the article for important intellectual content, final approval of the article. PR: acquisition, analysis and interpretation of the data, critical revision of the article for important intellectual content, final approval of the article. DF: analysis and interpretation of the data, critical revision of the article for important intellectual content, final approval of the article. RM: critical revision of the article for important intellectual content, final approval of the article.

Corresponding author

Correspondence to S. Ourô.

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The authors declare no conflicts of interest or disclosures.

Ethical approval

The present study was approved by the Ethics Committee and Institutional Review Board of Hospital Beatriz Ângelo and Hospital da Luz with no formal Informed consent required due to its methodology and anonymity. The study protocol was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments.

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All patients accepted this technique through informed consent.

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Ourô, S., Albergaria, D., Ferreira, M.P. et al. Transanal total mesorectal excision: 3-year oncological outcomes. Tech Coloproctol 25, 205–213 (2021). https://doi.org/10.1007/s10151-020-02362-y

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