Transanal Total Mesorectal Excision (TaTME) for Rectal Cancer: Short and Midterm Results

Colorectal cancer is the 3rd most common cancer affecting males and females in most western countries and is leading cause of cancer related deaths. . Transanal total mesorectal excision (TaTME) was introduced for mid and lower rectal cancer and is proposed to allow a precise mesorectal dissection through better visualization in anatomically limited pelvis.

Obective:

 To check the feasibility of Transanal Total Mesorectal Excision in terms of:- Quality of TME, Circumferential resection margin positivity, Lymph node yield, Operation time, Mean blood loss, Postoperative complications, Conversion rate, Hospital stay.

Out of the total patients studied, 34 patients(97.2%) had normal distal resection margin and only 1patient(2.8%) had positive distal resection margin. only 2(5.8%) patients were having positive circumferential resection margin while rest of 33 patients(94.2%) CRM was normal. The mean average of the tumor distance from anal verge was 4.97 cm with minimum 3cm and maximum7cm. The mean average of lymph node yield was 7.86 with minimum number of lymph nodes 5 and maximum 11 and standard deviation 1.734. The average mean of operation time was 2.095 hours with maximum time 3.5 hours and minimum time 1.3 hours with standard deviation of 0.4608. Mean average blood loss was 48.57ml with maximum blood loss 80ml and minimum of 30ml only with standard deviation 11.917. 25 patients with no post op complications at 1 month (71.4%),3 patients with UTI(8.6%), Surgical site infections in 2 patients(5.7%),AKI 1(2.9%),Anastamotic leak 1(2.9%), Incontinence 1(2.9%), stromal retraction 1(2.9%) and recto vaginal fistula 1(2.9%) patient. Out of the total patient studied, 31 patients were having no complication at 3 months(88.6%) followed by Sub acute intestinal obstruction in 2(5.7%) and sexual dysfunction in 2 patients(5.7%).

The present study suggest that Transanal TME is a feasible method for oncologic resection of locally advanced mid- and distal-rectal cancer with curative intent.