Published online Nov 7, 2015. doi: 10.3748/wjg.v21.i41.11700
Peer-review started: April 22, 2015
First decision: July 13, 2015
Revised: July 21, 2015
Accepted: September 14, 2015
Article in press: September 14, 2015
Published online: November 7, 2015
Low anterior resection can be a challenging operation, especially in obese male patients and in particular after radiotherapy. Transanal total mesorectal excision (TaTME) might offer technical advantages over laparoscopic or open approaches particularly for tumors in the distal third of the rectum. The aim of this article is to review the current experience with TaTME. The limits and future developments are also explored. Although the experience with TaTME is still limited, it might be a promising alternative to laparoscopic TME, especially for difficult cases where laparoscopy is too demanding. The preliminary data on complications and short-term oncological outcomes are good, but also emphasize the importance of careful patient selection. Finally, there is a need for large-scale trials focusing on long-term outcomes and oncological safety before widespread adoption can be recommended.
Core tip: The current literature regarding transanal total mesorectal excision of the rectum (TaTME) is presented. Outcomes are encouraging. TaTME might be a promising alternative to laparoscopic TME, especially for difficult cases where laparoscopy is too demanding. The limitations and future developments are explored.