Functional outcomes following transanal rectal surgery

Transanal rectal surgery and particularly transanal endoscopic microsurgery are becoming increasingly utilized in a variety of settings. In well-selected cases, oncologic outcomes are comparable to more radical techniques, and operative complications are decreased with the less invasive procedures. Due to the necessity for anal dilation during transanal approaches however, concern over functional outcomes has developed. As the medical community focused on these functional results however, it became clear that compared to radical resection, transanal surgery compares favorably; disturbances due to pelvic nerve injury are notably less, and though incontinence often presents early post-operatively, it dissipates and has little effect upon patient quality of life. Both patient- and surgeon-related factors appear to influence functional outcomes, allowing for both improvements in surgical technique and clarity of patient expectations.