Any of 4 Approaches to TME — Stick With What You Know Best

Background: Total mesorectal excision (TME) is the gold standard surgical therapy for mid-to-low rectal cancers, and several approaches to operative TME exist. Four different approaches to TME are currently available: laparotomy (open TME [OTME]), laparoscopic TME (LTME), robotic TME (RTME), and transanal TME (TaTME). These procedures can be particularly challenging in high-risk patients (HRPs), which can be often predictable preoperatively. No prior studies have demonstrated superiority of any specific approach. Some favor the RTME approach for these HRPs over other operative techniques. This is the first prospective Rectal Surgery Evaluation Trial (RESET), with the primary aim being to provide conclusive insights into the optimal technique for these challenging patients. Objective: To compare TME techniques combined with sphincter-sparing procedures in HRPs. Design: Prospective, observational, case-matched, 4-cohort, multicenter trial. Participants: Patients aged ≥18 years, with a more...