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De Nardi. Mini-invasive Surg 2018;2:20 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2018.30

Review Open Access

Functional results and quality of life after transanal
total mesorectal excision

Paola De Nardi

Gastrointestinal Surgery, San Raffaele Scientific Institute, Milan 20132, Italy.
Correspondence to: Dr. Paola De Nardi, San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy.
E-mail: denardi.paola@hsr.it
How to cite this article: De Nardi P. Functional results and quality of life after transanal total mesorectal excision. Mini-invasive
Surg 2018;2:20. http://dx.doi.org/10.20517/2574-1225.2018.30
Received: 28 May 2018 First Decision: 14 Jun 2018 Revised: 16 Jul 2018 Accepted: 17 Jul 2018 Published: 24 Jul 2018

Science Editor: Gordon N. Buchanan Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
This is a narrative review on ano-rectal, sexual, urinary, and quality of life outcomes after transanal total mesorectal
excision (TME). Little is known on this topic as only a few studies are currently available in the literature. According to
these, it appears that the functional results and quality of life are not substantially impaired compared with standard
TME. However more data are needed to precisely assess the outcomes of this technique.

Keywords: Rectal cancer, transanal total mesorectal excision, functional results, quality of life

INTRODUCTION
Rectal resection with total mesorectal excision (TME) is considered the standard treatment for cancer lo-
cated in the mid and low rectum, as it provides removal of the primary tumor together with the mesorectal
[1]
lymph nodes . However, TME for low rectal cancers, whether performed via an open or conventional lap-
aroscopic approach, is technically demanding, particularly in patients with unfavourable features such as
obese male patients, with a narrow pelvis or bulky tumor, where obtaining adequate resection margins can
be challenging. The transanal total mesorectal excision (taTME) technique has been recently introduced to
facilitate distal mobilization of the rectum and has raised great interest worldwide since it may overcome
[2]
some of the limitations encountered in abdominal TME .

Compared to standard laparoscopic TME, taTME has potential advantages: a superior quality of the speci-
[5,6]
[3,4]
men with better preservation of mesorectal integrity , a better anastomotic technique , no need for an
abdominal incision for specimen extraction, reduced incidence of wound problems , less conversions to
[7]
© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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