Long Term Functional Outcomes After Transabdominal Versus Transanal Total Mesorectal Excision: A Matched…

Cohort studyANZ journal of surgery· May 2026

Long Term Functional Outcomes After Transabdominal Versus Transanal Total Mesorectal Excision: A Matched Comparative Study.

Jayson Moloney, Steven Lau, Fraser Jeffery … David Clark

Colon & Rectal SurgeryCohort studyTreatmentQ2IF 1.0

Transanal excision linked to worse faecal incontinence scores than transabdominal approach

Long Term Functional Outcomes After Transabdominal Versus Transanal Total Mesorectal Excision: A Matched Comparative Study.

Jayson Moloney … David Clark

ANZ journal of surgery · May 2026 · Q2 in Surgery

Background

Transanal total mesorectal excision (total mesorectal excision) offers advantages for resection of low rectal tumours in patients with challenging access to the pelvis, but the functional outcomes relative to the conventional transabdominal approach are poorly understood.

Methods

Undergoing total mesorectal excision for cancer between 2009 and 2018 at nine sites across Australia and New Zealand were eligible.

n = 100 patients

Results

worse faecal incontinence scores after transanal excision than transabdominal

28.5EORTC

TaTME

18.8EORTC

Transabdominal

More results

In the total mesorectal excision group, 200 eligible patients were invited to participate, with 100 patients enrolled (survey response rate 50%).

Major low anterior resection syndrome was reported in 69.3% of patients.

There were no significant differences in other domains.

“

Conclusion

While it affords advantages when pelvic access is challenging, total mesorectal excision may compromise functional outcomes relative to the transabdominal approach, particularly regarding faecal incontinence.

Long Term Functional Outcomes After Transabdominal Versus Transanal Total Mesorectal Excision: A Matched Comparative Study.

Long Term Functional Outcomes After Transabdominal Versus Transanal Total Mesorectal Excision: A Matched Comparative Study.

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