Journal
CANCERS
Volume 15, Issue 4, Pages -Publisher
MDPI
DOI: 10.3390/cancers15041190
Keywords
rectal cancer; laparoscopic surgery; transanal total mesorectal excision; taTME; total mesorectal excision; local recurrence
Categories
Ask authors/readers for more resources
A study of 165 patients with distal rectal cancer who underwent taTME found that this procedure is a viable alternative to conventional TME, with high surgical quality and favorable outcomes.
Simple Summary A transanal total mesorectal excision (taTME) is a smart alternative to a conventional TME. Consecutive patients with distal rectal cancer treated by a taTME were prospectively analyzed. Median values were reported as outcomes measures. One hundred sixty-five patients (67% male and 33% female) with a tumor 7 cm from the anal verge were followed for 50 months. The resection margins were threatened in 25% of the patients, while 75% of the patients received neoadjuvant radiochemotherapy. A good mesorectal dissection and clear margins were achieved in 96% of the specimens, and 27 lymph nodes were harvested. Ninety-day major morbidity affected 36 patients (21.8%), including 12 with anastomotic leakages (7.2%). A recurrence occurred locally in 9 patients (5.4%), and 44 patients had distant metastasis (26.7%). The five-year disease-free survival and overall survival were 67% and 90%, respectively. A two-team taTME saved 102 min of operative time and EUR 1385 when compared to a one-team approach. Transanal total mesorectal excision produced sound surgical quality and excellent oncologic outcomes. A transanal total mesorectal excision (taTME) is a smart alternative to a conventional TME. However, worrisome reports of a high recurrence and complications triggered a moratorium in a few countries. This study assessed the outcomes and resource utilization of a taTME. Consecutive patients with distal rectal cancer treated by a taTME were prospectively included. Outcomes were reported as the median and interquartile range (IQR). One hundred sixty-five patients (67% male and 33% female) with a tumor 7 cm (IQR 5-10) from the anal verge were followed for 50 months (IQR 32-79). The resection margins were threatened in 25% of the patients, while 75% of the patients received neoadjuvant radiochemotherapy. A good mesorectal dissection and clear margins were achieved in 96% of the specimens, and 27 lymph nodes (IQR 20-38) were harvested. Ninety-day major morbidity affected 36 patients (21.8%), including 12 with anastomotic leakages (7.2%). A recurrence occurred locally in 9 patients (5.4%), and 44 patients had a distant metastasis (26.7%). The five-year disease-free survival and overall survival were 67% and 90%, respectively. A multivariate analysis found a long operation and frailty predicted an anastomotic leak, while a positive distal margin and lymph nodes predicted a local recurrence and distant metastasis. A two-team taTME saved 102 min of operative time and EUR 1385 when compared to a one-team approach. Transanal total mesorectal excision produced sound surgical quality and excellent oncologic outcomes.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available