Emile, SH;
de Lacy, FB;
Keller, DS;
Martin-Perez, B;
Alrawi, S;
Lacy, AM;
Chand, M;
(2018)
Evolution of transanal total mesorectal excision for rectal cancer: From top to bottom.
World Journal of Gastrointestinal Surgery
, 10
(3)
pp. 28-39.
10.4240/wjgs.v10.i3.28.
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Abstract
The gold standard for curative treatment of locally advanced rectal cancer involves radical resection with a total mesorectal excision (TME). TME is the most effective treatment strategy to reduce local recurrence and improve survival outcomes regardless of the surgical platform used. However, there are associated morbidities, functional consequences, and quality of life (QoL) issues associated with TME; these risks must be considered during the modern-day multidisciplinary treatment for rectal cancer. This has led to the development of new surgical techniques to improve patient, oncologic, and QoL outcomes. In this work, we review the evolution of TME to the transanal total mesorectal excision (TaTME) through more traditional minimally invasive platforms. The review the development, safety and feasibility, proposed benefits and risks of the procedure, implementation and education models, and future direction for research and implementation of the TaTME in colorectal surgery. While satisfactory short-term results have been reported, the procedure is in its infancy, and long term outcomes and definitive results from controlled trials are pending. As evidence for safety and feasibility accumulates, structured training programs to standardize teaching, training, and safe expansion will aid the safe spread of the TaTME.
| Type: | Article |
|---|---|
| Title: | Evolution of transanal total mesorectal excision for rectal cancer: From top to bottom |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.4240/wjgs.v10.i3.28 |
| Publisher version: | http://dx.doi.org/10.4240/wjgs.v10.i3.28 |
| Language: | English |
| Additional information: | This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/ licenses/by-nc/4.0/. |
| Keywords: | Rectal cancer, Total mesorectal excision, Transanal total mesorectal excision, Transanal total mesorectal excision, Sphincter sparing surgery, Colorectal surgery |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10047084 |
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