Perceptions of transanal total mesorectal excision surgical quality and patient screening
10.3760/cma.j.cn441530-20240328-00112
- VernacularTitle:对经肛全直肠系膜切除手术质量控制的思考
- Author:
Kexuan LI
1
;
Yi XIAO
Author Information
1. 中国医学科学院北京协和医学院 北京协和医院基本外科结直肠专业组，北京 100730
- Keywords:
Rectal neoplasms;
Transanal total mesorectal excision;
Surgical quality control
- From:
Chinese Journal of Gastrointestinal Surgery
2024;27(6):564-568
- CountryChina
- Language:Chinese
-
Abstract:
As a rapid developing rectal cancer procedure that has been in existence for more than a decade, transanal total mesorectal excision (taTME) has had a rough experience along the way, suggesting the importance of improving its surgical quality. In the current view of quality control of taTME, its main advantages are that it could increase the distance of distal margins, reduce the positive rate of circumferential margins, and improve the quality of total mesorectal excision. As few high-quality clinical studies have been conducted, the limitations brought about by confounding bias and publication bias that could not be excluded in current published studies call for a cautious interpretation of the current conclusions. At this stage taTME is only recommended in highly selective patients and centers. Under these circumstances, we aim to discuss the quality assessment of the taTME procedure and the selection of patients and centers. Based on current evidence and practical experience, we typically select patients with difficult pelvis, low rectal cancer, and/or those requiring direct visual recognition of the distal margin after neoadjuvant chemoradiation to perform taTME in our center.
