Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 10, 2016; 7(5): 337-339
Published online Oct 10, 2016. doi: 10.5306/wjco.v7.i5.337
Transanal total mesorectal excision: Myths and reality
Nicolas C Buchs, Marta Penna, Alexander L Bloemendaal, Roel Hompes
Nicolas C Buchs, Division of Visceral Surgery, Department of Surgery, University Hospitals of Geneva, 1211 Geneva, Switzerland
Nicolas C Buchs, Marta Penna, Alexander L Bloemendaal, Roel Hompes, Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford OX3 7LE, United Kingdom
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: Roel Hompes is a regular faculty member for TAMIS courses organized by Applied Medical. The other authors have no financial disclosure or conflict of interest.
Open-Access: 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/
Correspondence to: Nicolas C Buchs, MD, Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Old Road, Oxford OX3 7LE, United Kingdom. nicolas.c.buchs@hcuge.ch
Telephone: +44-1865-741841 Fax: +44-1865-235857
Received: June 27, 2016
Peer-review started: June 28, 2016
First decision: August 5, 2016
Revised: September 2, 2016
Accepted: September 21, 2016
Article in press: September 23, 2016
Published online: October 10, 2016

Transanal total mesorectal excision (TaTME) is a new and promising approach for the treatment of rectal cancer. Whilst the experience is still limited, there are growing evidences that this approach might overcome the limits of standard low anterior resection. TaTME might help to decrease the conversion rate especially in difficult patients, and to improve the pathological results, while preserving the urogenital function. Evaluation of data from large registries and randomized studies should help to draw firmer conclusions. Beyond these technical considerations, the next challenge seems to be clearly the safe introduction of this approach, motivating the development of dedicated courses.

Keywords: Transanal total mesorectal excision, Bottom up, TAMIS, Laparoscopy, Robotic, Outcomes, Rectal cancer

Core tip: The experience and evidences regarding the use of transanal total mesorectal excision is still scarce but promising. Preliminary data showed excellent results, without sacrificing the pathological and oncological outcomes. Whilst still in its infancy, further investigations should be encouraged. Data from large registries and randomized trials are awaited before to draw definitive conclusions.