%0 Journal Article
%T Transanal total mesorectal excision: short- and long-term results of four certified colorectal cancer centers in Germany.
%A Grundler E
%A Gerken M
%A Schatz S
%A Dittrich L
%A Biebl M
%A Rink AD
%A Kneist W
%A Aigner F
%A Völkel V
%A Fürst A
%J Int J Colorectal Dis
%V 39
%N 1
%D 2024 Aug 15
%M 39145821
%F 2.796
%R 10.1007/s00384-024-04704-w
%X BACKGROUND: Transanal total mesorectal excision (TaTME), a novel approach for treating low rectal cancer, holds promise. However, concerns exist in certain countries about their oncologic safety due to less-than-optimal outcomes on global studies. This research seeks to evaluate the long-term oncologic outcomes focusing on local recurrence rate and overall survival after TaTME surgery in Germany.
METHODS: This study analyzed data from patients who underwent elective TaTME surgery between 2014 and 2021 in four certified colorectal cancer centers in Germany. Primary endpoints were 3-year local recurrence rate and local recurrence-free survival (LRFS). Secondary outcomes encompassed overall survival (OS), operative time, completeness of local tumor resection, lymph node resection, and postoperative complications.
RESULTS: A total of 378 patients were analyzed (mean age 61.6 years; 272 males, 72%). After a median follow-up period of 2.5 years, 326 patients with UICC-stages I-III and tumor operability included in survival analyses. Local recurrence was observed in 8 individuals, leading to a 3-year cumulative local recurrence rate of 2.2% and a 3-year LRFS rate of 88.1%. The 3-year OS rate stood at 88.9%. Within 30 days after surgery, anastomotic leakage occurred in 19 cases (5%), whereas a presacral abscess was present in 12 patients (3.2%).
CONCLUSIONS: TaTME proves effective in addressing the anatomical and technical challenges of low rectal surgery and is associated with pleasing short- and long-term results. However, its safe integration into surgical routine necessitates sufficient knowledge and a previously completed training program.