Transanal total mesorectal excision for low rectal cancer: a case-matched study comparing TaTME versus standard laparoscopic TME

Figures & data

Table 1 Demographical characteristics

	LaTME	TaTME	P-value
Number of patients	35	35
Age	60.3±10.2	64.3±10.1	0.08
Sex (women)	11 (31%)	11 (31%)	1.00
Body mass index (kg/m^2)	27.1±4.71	26.1±4.09	0.22
Distance of the tumor from the anal verge (cm)	3.19±1.47 (range 1–5)	2.9±1.17 (range 1–5)	0.47
ASA	I-6	I-8	0.60
	II-20	II-19
	III-9	III-8
Preoperative neoadjuvant treatment (yes/no)	31/4	31/4	1
Type of anastomosis (stapled/hand-sewn)	29/6	30/5	0.74

Abbreviations: ASA, American Society of Anesthesiologists Classification; LaTME, laparoscopic total mesorectal excision; TaTME, transanal total mesorectal excision.

Table 2 Number of complications

Clavien–Dindo grade	LaTME	N (%)	TaTME	N (%)
V				0
IV			Anastomotic leakage with concomitant sepsis (operative treatment)	1 (3)
IIIb	Anastomotic leakage (operative treatment) Postoperative ileus (operative treatment)	2 (6) 1 (3)	Anastomotic leakage	2 (6)
IIIa	Anastomotic leakage (percutaneus drainage of the near-anastomotic abscess)	1 (3)		0
II	High output stoma Anastomotic leakage (conservative treatment)	1 (3) 2 (6)	Postoperative ileus (conservative treatment)	2 (6)
I	Postoperative fever of unknown origin	1 (3)	Radial nerve paresis (due to prolonged compression on the operating table)	1 (3)
Total		8 (23)		6 (17)

Abbreviations: LaTME, laparoscopic total mesorectal excision; TaTME, transanal total mesorectal excision.

Table 3 Outcomes assessment

	LaTME	TaTME	P-value
Primary outcome
n (%) of patients with negative pCRM and pDRM and complete mesorectal excision	29/35 (83%)	30/35 (86%)	0.74
Primary outcome components
pCRM ≥1 mm	35/35 (100%)	34/35 (97%)	0.25
pDRM ≥1 mm	34/35 (97%)	35/35 (100%)	0.25
Total mesorectal excision, n (%)
Complete	29/35 (83)	31/35 (89)	0.23
Nearly complete	6/35 (17)	4/35 (11)
Incomplete	0/35 (0)	0/35 (0)
Secondary outcomes
Surgery duration (mean)	219±45 minutes	271±63 minutes	0.00
Blood loss (mean)	113±75 mL	165±148 mL	0.07
Postoperative complications	8 (22%)	6 (17%)	0.55
Serious complications (CD 3–5)	4 (11%)	3 (9%)	0.69
AJCC stage	0–7	0–8	0.58
	1–7	1–3
	2–10	2–10
	3–11	3–14
	4–0	4–0
Pathological TNM staging
pT
0	7	8	0.93
1	6	5
2	3	3
3	19	19
4	0	0
pN
0	24	21	0.58
1	6	8
2	4	5

Abbreviations: AJCC, American Joint Committee on Cancer; LaTME, laparoscopic total mesorectal excision; pCRM, circumferential resection margin; pDRM, distal resection margin; TaTME, transanal total mesorectal excision.