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Transanal total mesorectal excision for rectal cancer

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Abstract

Although laparoscopic surgery for rectal cancer has been gaining acceptance with the gradual accumulation of evidence, it remains a technically demanding procedure in patients with a narrow pelvis, bulky tumors, or obesity. To overcome the technical difficulties associated with laparoscopic rectal dissection and transection, transanal endoscopic rectal dissection, which is also referred to as transanal (reverse, bottom-up) total mesorectal excision (TME), has recently been introduced. Its potential advantages include the facilitation of the dissection of the anorectum, regardless of the patient body habitus, and a clearly defined safe distal margin and transanal extraction of the specimen. This literature review shows that this approach seems to be feasible with regard to the operative and short-term postoperative outcomes. In experienced hands, transanal TME is a promising method for the resection of mid- and low-rectal cancers. Further investigations are required to clarify the long-term oncological and functional outcomes.

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Conflict of interest

Suguru Hasegawa, Ryo Takahashi, Koya Hida, Kenji Kawada, and Yoshiharu Sakai declare no conflicts of interest in association with the present study.

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Authors and Affiliations

  1. Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan

    Suguru Hasegawa, Ryo Takahashi, Koya Hida, Kenji Kawada & Yoshiharu Sakai

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  1. Suguru Hasegawa
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  2. Ryo Takahashi
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  3. Koya Hida
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  4. Kenji Kawada
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  5. Yoshiharu Sakai
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Correspondence to Suguru Hasegawa.

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Hasegawa, S., Takahashi, R., Hida, K. et al. Transanal total mesorectal excision for rectal cancer. Surg Today 46, 641–653 (2016). https://doi.org/10.1007/s00595-015-1195-2

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  • DOI: https://doi.org/10.1007/s00595-015-1195-2

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