{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T15:30:41Z","timestamp":1782055841771,"version":"3.54.5"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Narrow pelvis, tumor diameter, and obesity have been reported as clinical variables correlated with the difficulty of conventional laparoscopic low anterior resection (Lap\u2010LAR). A two\u2010team transanal total mesorectal excision (TaTME) approach where the transabdominal and TaTME are performed simultaneously might reduce the difficulty associated with these factors. This study aimed to clarify the factors associated with the longer time required for TME (TME time) in conventional Lap\u2010LAR and a two\u2010team approach for TaTME.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed 52 patients with rectal carcinoma treated with Lap\u2010LAR and 35 patients treated with TaTME. We performed simple linear regression analysis to assess the association between TME time and bony pelvic size using 3D pelvimetry, longest tumor diameter, and body mass index (BMI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Linear regression analysis demonstrated a highly significant association between TME time and obstetric conjugate (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.098, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.024) and BMI (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.307, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) in the Lap\u2010LAR group, while no significant association was observed in the TaTME group. Male patients, who had a narrower bony pelvis and higher BMI than female patients, had longer TME time than female patients in the Lap\u2010LAR group (213\u2009minutes vs 172\u2009minutes, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.021), while the TME time of male and female patients did not differ in the TaTME group (122\u2009minutes vs 108\u2009minutes, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.451). The TME time in the TaTME group was significantly shorter than that in the Lap\u2010LAR group (121\u2009minutes vs 197\u2009minutes, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A two\u2010team TaTME approach provided a shorter TME time compared to conventional Lap\u2010LAR, regardless of pelvic size and BMI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ases.13134","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T03:44:45Z","timestamp":1664941485000},"page":"189-196","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Obesity and narrow pelvis prolong the operative time in conventional laparoscopic rectal cancer surgery, but not in a two\u2010team transanal total mesorectal excision approach"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1545-0509","authenticated-orcid":false,"given":"Hiroshi","family":"Hasegawa","sequence":"first","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9541-856X","authenticated-orcid":false,"given":"Takeru","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Division of Minimally Invasive Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4208-7138","authenticated-orcid":false,"given":"Kimihiro","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichiro","family":"Sawada","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Harada","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Urakawa","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironobu","family":"Goto","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8698-8923","authenticated-orcid":false,"given":"Shingo","family":"Kanaji","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0635-3432","authenticated-orcid":false,"given":"Taro","family":"Oshikiri","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2727-0241","authenticated-orcid":false,"given":"Yoshihiro","family":"Kakeji","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Kobe University 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