BACKGROUND: Transanal total mesorectal excision is a novel and promising technique in the treatment of low and middle rectal cancer. OBJECTIVE: This study aimed to compare the safety and feasibility of transanal total mesorectal excision versus laparoscopic total mesorectal excision. DESIGN: This was a retrospective study using propensity score matching analysis. SETTINGS: This study was conducted in a single high-volume university hospital. PATIENTS: Patients with low and middle rectal cancer who underwent total mesorectal excision with curative intent between 2007 and 2017 were recruited. INTERVENTIONS: Laparoscopic total mesorectal excision and transanal total mesorectal excision had been performed. MAIN OUTCOME MEASURES: Intraoperative, pathological, and 30-day postoperative outcomes were compared between the transanal and laparoscopic groups. RESULTS: Overall, 105 patients were selected from the whole sample of 316 patients with rectal cancer. After propensity score matching analysis, 46 patients for each group were compared. Laparoscopic total mesorectal excision was associated with a higher conversion rate to open surgery (19.6% vs 0%, p = 0.002). Transanal total mesorectal excision showed a longer distal resection margin (15 mm vs 25 mm; p < 0.001), and similar results regarding the completeness of mesorectal excision and circumferential resection margin involvement, compared to laparoscopy. There were no statistically significant differences between the 2 groups in terms of postoperative complications. LIMITATIONS: The study was limited by its retrospective design and the small size of the sample. CONCLUSIONS: Transanal total mesorectal excision is a safe and feasible technique that results in a high-quality rectal cancer resection specimen and favorable 30-day postoperative outcomes.
BACKGROUND: Transanal total mesorectal excision is a novel and promising technique in the treatment of low and middle rectal cancer. OBJECTIVE: This study aimed to compare the safety and feasibility of transanal total mesorectal excision versus laparoscopic total mesorectal excision. DESIGN: This was a retrospective study using propensity score matching analysis. SETTINGS: This study was conducted in a single high-volume university hospital. PATIENTS: Patients with low and middle rectal cancer who underwent total mesorectal excision with curative intent between 2007 and 2017 were recruited. INTERVENTIONS: Laparoscopic total mesorectal excision and transanal total mesorectal excision had been performed. MAIN OUTCOME MEASURES: Intraoperative, pathological, and 30-day postoperative outcomes were compared between the transanal and laparoscopic groups. RESULTS: Overall, 105 patients were selected from the whole sample of 316 patients with rectal cancer. After propensity score matching analysis, 46 patients for each group were compared. Laparoscopic total mesorectal excision was associated with a higher conversion rate to open surgery (19.6% vs 0%, p = 0.002). Transanal total mesorectal excision showed a longer distal resection margin (15 mm vs 25 mm; p < 0.001), and similar results regarding the completeness of mesorectal excision and circumferential resection margin involvement, compared to laparoscopy. There were no statistically significant differences between the 2 groups in terms of postoperative complications. LIMITATIONS: The study was limited by its retrospective design and the small size of the sample. CONCLUSIONS: Transanal total mesorectal excision is a safe and feasible technique that results in a high-quality rectal cancer resection specimen and favorable 30-day postoperative outcomes.
Authors: K Zaghiyan; J Warusavitarne; A Spinelli; P Chandrasinghe; F Di Candido; P Fleshner Journal: Tech Coloproctol Date: 2018-12-11 Impact factor: 3.781
Authors: Mateusz Rubinkiewicz; Agata Czerwińska; Piotr Zarzycki; Piotr Małczak; Michał Nowakowski; Piotr Major; Andrzej Budzyński; Michał Pędziwiatr Journal: J Clin Med Date: 2018-11-19 Impact factor: 4.241
Authors: C L Sparreboom; N Komen; D Rizopoulos; H L van Westreenen; P G Doornebosch; J W T Dekker; A G Menon; J B Tuynman; F Daams; D Lips; W M U van Grevenstein; T M Karsten; J F Lange; A D'Hoore; A M Wolthuis Journal: Colorectal Dis Date: 2019-03-26 Impact factor: 3.788
Authors: Sapho Xenia Roodbeen; Marta Penna; Hugh Mackenzie; Miranda Kusters; Andrew Slater; Oliver M Jones; Ian Lindsey; Richard J Guy; Chris Cunningham; Roel Hompes Journal: Surg Endosc Date: 2018-10-22 Impact factor: 4.584
Authors: Mateusz Rubinkiewicz; Katarzyna Truszkiewicz; Michał Wysocki; Jan Witowski; Grzegorz Torbicz; Michal M Nowakowski; Andrzej Budzynski; Michał Pędziwiatr Journal: Wideochir Inne Tech Maloinwazyjne Date: 2019-02-05 Impact factor: 1.195