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CC BY-NC-ND 4.0 · Journal of Coloproctology 2021; 41(04): 411-418
DOI: 10.1055/s-0041-1736640
Original Article

Quality Indicators of Transanal Total Mesorectal Excision (TaTME) for Rectal Cancer

María Labalde Martínez 
1   Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Alfredo Vivas Lopez 
1   Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Juan Ocaña Jimenez 
1   Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Cristina Nevado García
1   Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Oscar García Villar 
1   Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Eduardo Rubio Gonzalez
1   Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Francisco Javier García Borda 
1   Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Felipe Cruz Vigo 
1   Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Eduardo Ferrero Herrero 
1   Unit of Colorectal Surgery, Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain
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Abstract

Introduction Transanal total mesorectal excision (TaTME) has revolutionized the surgical techniques for lower-third rectal cancer. The aim of the present study was to analyze the outcomes of quality indicators of TaTME for rectal cancer compared with laparoscopic TME (LaTME).

Methods A cohort prospective study with 50 (14 female and 36 male) patients, with a mean age of 67 (range: 55.75 to 75.25) years, who underwent surgery for rectal cancer. In total, 20 patients underwent TaTME, and 30, LaTME. Every TaTME procedure was performed by experienced colorectal surgeons. The sample was divided into two groups (TaTME and LaTME), and the quality indicators of the surgery for rectal cancer were analyzed.

Results There were no statistically significant differences regarding the patients and the main characteristics of the tumor (age, gender, American Society of Anesthesiologists [ASA] score, body mass index [BMI], tumoral stage, neoadjuvant therapy, and distance from the tumor to the external anal margin) between the two groups. The rates of: postoperative morbidity (TaTME: 35%; LaTME: 30%; p = 0.763); mortality (0%); anastomotic leak (TaTME: 10%; LaTME: 13%; p = 0.722); wound infection (TaTME: 0%; LaTME: 3.3%; p = 0.409); reoperation (TaTME: 5%; LaTME: 6.6%; p = 0.808); and readmission (TaTME: 5%; LaTME: 0%; p = 0.400), as well as the length of the hospital stay (TaTME: 13.5 days; LaTME: 11 days; p = 0.538), were similar in both groups. There were no statistically significant differences in the rates of positive circumferential resection margin (TaTME: 5%; LaTME: 3.3%; p = 0.989) and positive distal resection margin (TaTME: 0%; LaTME: 3.3%; p = 0.400), the completeness of the TME (TaTME: 100%; LaTME: 100%), and the number of lymph nodes harvested (TaTME: 15; LaTME: 15.5; p = 0.882) between two groups.

Conclusion Transanal total mesorectal excision is a safe and feasible surgical procedure for middle/lower-third rectal cancer.

Keywords

rectal cancer - transanal total mesorectal excision rectal cancer surgery - TaTME - quality indicators of rectal cancer surgery


Publication History

Received: 20 February 2021

Accepted: 15 June 2021

Article published online:
13 December 2021

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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