Multicenter phase II trial of transanal total mesorectal excision for rectal cancer: preliminary results.

Document Type

Article

Publication Date

9-12-2023

Publication Title

Surgical endoscopy

Keywords

oregon; portland; Anastomotic complication; Circumferential radial margin; Conversion; Rectal cancer; Stoma-free rate; TME grade; Transanal total mesorectal excision

Abstract

BACKGROUND: Transanal TME (taTME) combines abdominal and transanal dissection to facilitate sphincter preservation in patients with low rectal tumors. Few phase II/III trials report long-term oncologic and functional results. We report early results from a North American prospective multicenter phase II trial of taTME (NCT03144765).

METHODS: 100 patients with stage I-III rectal adenocarcinoma located ≤ 10 cm from the anal verge (AV) were enrolled across 11 centers. Primary and secondary endpoints were TME quality, pathologic outcomes, 30-day and 90-day outcomes, and stoma closure rate. Univariable regression analysis was performed to assess risk factors for incomplete TME and anastomotic complications.

RESULTS: Between September 2017 and April 2022, 70 males and 30 females with median age of 58 (IQR 49-62) years and BMI 27.8 (IQR 23.9-31.8) kg/m

CONCLUSION: When performed at expert centers, 2-team taTME in patients with low rectal tumors is safe with low conversion rates and high stoma closure rate. Mid-term results will further evaluate oncologic and functional outcomes.

Clinical Institute

Cancer

Clinical Institute

Digestive Health

Department

Gastroenterology

Department

Oncology

Department

Surgery

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