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Updates in Surgery

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08.02.2019 | Review Article

Transanal total mesorectal excision (TaTME): current status and future perspectives

verfasst von: Andrea Vignali, Ugo Elmore, Marco Milone, Riccardo Rosati

Erschienen in: Updates in Surgery | Ausgabe 1/2019

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Abstract

Total mesorectal excision (TME) is the gold standard surgical treatment for mid- and low rectal cancer; however, it is associated with specific technical hurdles. Transanal TME (TaTME) is a new procedure developed to overcome these difficulties, through an enhanced visualization of the dissection plane. This potentially could result in a more accurate distal dissection with a lower rate of positive circumferential resection margins, increasing the rate of sphincter-saving procedures. The indications for TaTME are currently expanding, despite not being yet standardized, and structured training programs are ongoing to help overcome the steep learning curve related to the technique. The procedure is feasible and safe with similar intraoperative complications and readmission rates when compared with conventional open or laparoscopic TME. Favorable short-term oncologic results have been reported: in particular, TaTME is associated with mesorectal specimen of a better quality and a longer distal resection margin that is established at the beginning of the procedure under direct view. Robotics, when available, will probably overcome the steep learning curve related to the complexity of TaTME. Long-term follow-up and ongoing RCT trials data are awaited regarding functional results, local recurrence and survival, and to facilitate the comparison with standard laparoscopic or robotic rectal resections. The present review is focused on critically analyzing the theoretical benefits and risks of the procedure, its indications, short- and long-term results and future direction in the application of TaTME.

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Titel: Transanal total mesorectal excision (TaTME): current status and future perspectives
verfasst von: Andrea Vignali
Ugo Elmore
Marco Milone
Riccardo Rosati
Publikationsdatum: 08.02.2019
Verlag: Springer International Publishing
Erschienen in: Updates in Surgery / Ausgabe 1/2019
Print ISSN: 2038-131X
Elektronische ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-019-00630-7

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Right colectomy: consecutive 100 patients treated with laparoscopic and robotic technique for malignancy. Cumulative experience in a single centre

SICE national survey: current state on the adoption of laparoscopic approach to the treatment of colorectal disease in Italy

Update Chirurgie