The ACPGBI recommends pause for reflection on transanal total mesorectal excision.

Keywords: Ileoanal pouch; outcomes; rectal cancer; total mesorectal excision; transanal EN Ileoanal pouch outcomes rectal cancer total mesorectal excision transanal 745 748 4 07/27/20 20200701 NES 200701 The Association of Coloproctology of Great Britain and Ireland (ACPGBI) has noted with concern the results of transanal total mesorectal excision (TME) procedures reported by the Norwegian Colorectal Cancer Registry, recently published in the I British Journal of Surgery i [1]. Short-term outcomes from the International Transanal TME registry were reported on 2653 patients undergoing a transanal TME approach for rectal cancer between 2014 and 2018 [12]. The annual institutional caseload of 25 transanal TME procedures is set at the lower limit of the 25 to >40 transanal rectal cancer resections recommended by the latest international transanal TME consensus, to which the ACPGBI contributed (R. Hompes, pers.comm.). [Extracted from the article]