Transanal Total Mesorectal Resection for Rectal Cancer.

This article examines the development of transanal total mesorectal excision (taTME) as a surgical approach for rectal cancer. TaTME is an alternative "bottoms up" approach that improves visualization and control of the distal margin, particularly for low tumors in male patients with visceral obesity and a narrow pelvis. Although it carries a steep learning curve, taTME has comparable short-term oncologic outcomes to laparoscopic TME when performed by experienced surgeons. TaTME may also offer the benefit of low open conversion and higher rates of sphincter preservation for low rectal tumors.