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The mean age ranged from 43 to 80\u00a0years and the mean body mass index from 21.7 to 31.8\u00a0kg\/m<jats:sup>2<\/jats:sup>. The mean distance of the tumour from the anal verge ranged from 4 to 9.7\u00a0cm. The mean operation time ranged from 143 to 450\u00a0min and mean operative blood loss from 22 to 225\u00a0ml. The ratio of hand\u2010sewn coloanal to stapled anastomoses performed was 2:1. One death was reported and the peri\u2010operative morbidity rate was 35%. The anastomotic leakage rate was 6.1% and the reoperation rate was 3.7%. The mean hospital stay ranged from 4.3 to 16.6\u00a0days. The mesorectal excision was described as complete in 88% cases, nearly complete in 6% and incomplete in 6%. The circumferential resection margin was negative in 95% of cases and the distal resection margin was negative in 99.7%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ta<jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> is a feasible and reproducible technique, with good quality of oncological resection. Standardization of the technique is required with formal training. Clear indications for this procedure need to be defined and its safety further assessed in future trials.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13151","type":"journal-article","created":{"date-parts":[[2015,10,15]],"date-time":"2015-10-15T09:05:47Z","timestamp":1444899947000},"page":"19-36","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":103,"title":["A systematic review of transanal total mesorectal excision: is this the future of rectal cancer surgery?"],"prefix":"10.1111","volume":"18","author":[{"given":"C.","family":"Simillis","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Royal Marsden Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Hompes","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust Churchill Hospital Headington Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Penna","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust Churchill Hospital Headington Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Rasheed","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Marsden Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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