The effectiveness of double team for transanal total mesorectal excision in treatment of mid-low rectal cancer

Introduction: Transanal total mesorectal (TaTME) is an emerging surgical technique for mid-low rectal cancer. This study investigated the double-team TaTME on the short-term morbidity, quality of surgical specimens, and functional and oncologic outcomes by comparing them with the single-team TaTME. Methods: We analyzed the surgical results of 72 patients (n = 40 double-team TaTME, n = 32 single-team TaTME) with mid-low rectal cancer who treated for mid-low rectal cancer with single-team TaTME or double-team TaTME. Results: The operative time was significantly shorter with a double-team TaTME (180 +/- 45 min) than with a single-team TaTME (230 +/- 55 min). Also, there were no intraoperative events recorded in both groups. The rate of pre-sacral abscesses complications (grade III) in the double-team (0%) was significantly lower than in the single-team group (3, 9.4%). The proportions of TME grade I, TME grade II, and TME grade III were not significantly different between the single-team and double-team groups. A positive circumferential resection margin (CRM) was not significantly different between the double-team groups (2, 5.0%) and the single-team (3, 9.3%). The mean low anterior resection syndrome (LARS) scores were lower in the double-team group (27 +/- 4.5) than in the single-team group (29 +/- 3.8) (p = 0.048). Simultaneously, the disease-free survival (DFS) rate was not significantly different between the two groups. Conclusion: The double-team TaTME in treatment of mid-low rectal cancer is effective with the shortness of operative time, the lower rate of the postoperative pre-sacral abscess, and LARS scores, while this method guaranteed the quality of mesorectal specimens and the DFS rate. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of Surgical Associates Ltd.