Functional outcomes after resections for low rectal tumors: comparison of Transanal with laparoscopic Total Mesorectal excision
Abstract Background Aim of this study was to evaluate functional outcomes of transanal total mesorectal excision (TaTME) in comparison to conventional laparoscopic approach (LaTME) in terms of low anterior resection syndrome (LARS). Methods Forty-six patients who underwent total mesorectal excision...
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| Language: | English |
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BMC
2019-07-01
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| Series: | BMC Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s12893-019-0550-4 |
| _version_ | 1818521690785710080 |
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| author | Mateusz Rubinkiewicz Piotr Zarzycki Jan Witowski Magdalena Pisarska Natalia Gajewska Grzegorz Torbicz Michał Nowakowski Piotr Major Andrzej Budzyński Michał Pędziwiatr |
| author_facet | Mateusz Rubinkiewicz Piotr Zarzycki Jan Witowski Magdalena Pisarska Natalia Gajewska Grzegorz Torbicz Michał Nowakowski Piotr Major Andrzej Budzyński Michał Pędziwiatr |
| author_sort | Mateusz Rubinkiewicz |
| collection | DOAJ |
| description | Abstract Background Aim of this study was to evaluate functional outcomes of transanal total mesorectal excision (TaTME) in comparison to conventional laparoscopic approach (LaTME) in terms of low anterior resection syndrome (LARS). Methods Forty-six patients who underwent total mesorectal excision for low rectal cancer between 2013 and 2017 were enrolled. Primary outcome was the severity of faecal incontinence, assessed both before the treatment and 6 months after ileostomy reversal. LARS score and Jorge-Wexner scale were utilized to analyze its severity. Results Twenty (87%) from TaTME and 21 (91%) from LaTME group developed LARS postoperatively. There were no significant differences between groups in terms of LARS occurrence (p = 0.63) and severity. The median Wexner score was comparable in both groups (8 [IQR: 4–12] vs 7 [3–11], p = 0.83). Univariate analysis revealed that postoperative complications were a risk factor for LARS development (p = 0.02). Perioperative outcomes, including operative time, blood loss and intraoperative adverse events did not differ significantly between groups either. Five TaTME patients developed postoperative complications, while there were morbidity 6 cases in LaTME group. Quality of mesorectal excision was comparable with 20 and 19 complete cases in TaTME and LaTME groups, respectively. Conclusions TaTME provided comparable outcomes in terms of functional outcomes in comparison to LaTME for total mesorectal excision in low rectal cancers. Having said that, LARS prevalence is still high and requires further evaluation of the technique. |
| first_indexed | 2024-12-11T01:54:47Z |
| format | Article |
| id | doaj.art-58d276c1df6a4a939a7283768200457e |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-11T01:54:47Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-58d276c1df6a4a939a7283768200457e2022-12-22T01:24:39ZengBMCBMC Surgery1471-24822019-07-011911610.1186/s12893-019-0550-4Functional outcomes after resections for low rectal tumors: comparison of Transanal with laparoscopic Total Mesorectal excisionMateusz Rubinkiewicz0Piotr Zarzycki1Jan Witowski2Magdalena Pisarska3Natalia Gajewska4Grzegorz Torbicz5Michał Nowakowski6Piotr Major7Andrzej Budzyński8Michał Pędziwiatr92nd Department of General Surgery, Jagiellonian University Medical College2nd Department of General Surgery, Jagiellonian University Medical College2nd Department of General Surgery, Jagiellonian University Medical College2nd Department of General Surgery, Jagiellonian University Medical College2nd Department of General Surgery, Jagiellonian University Medical College2nd Department of General Surgery, Jagiellonian University Medical College2nd Department of General Surgery, Jagiellonian University Medical College2nd Department of General Surgery, Jagiellonian University Medical College2nd Department of General Surgery, Jagiellonian University Medical College2nd Department of General Surgery, Jagiellonian University Medical CollegeAbstract Background Aim of this study was to evaluate functional outcomes of transanal total mesorectal excision (TaTME) in comparison to conventional laparoscopic approach (LaTME) in terms of low anterior resection syndrome (LARS). Methods Forty-six patients who underwent total mesorectal excision for low rectal cancer between 2013 and 2017 were enrolled. Primary outcome was the severity of faecal incontinence, assessed both before the treatment and 6 months after ileostomy reversal. LARS score and Jorge-Wexner scale were utilized to analyze its severity. Results Twenty (87%) from TaTME and 21 (91%) from LaTME group developed LARS postoperatively. There were no significant differences between groups in terms of LARS occurrence (p = 0.63) and severity. The median Wexner score was comparable in both groups (8 [IQR: 4–12] vs 7 [3–11], p = 0.83). Univariate analysis revealed that postoperative complications were a risk factor for LARS development (p = 0.02). Perioperative outcomes, including operative time, blood loss and intraoperative adverse events did not differ significantly between groups either. Five TaTME patients developed postoperative complications, while there were morbidity 6 cases in LaTME group. Quality of mesorectal excision was comparable with 20 and 19 complete cases in TaTME and LaTME groups, respectively. Conclusions TaTME provided comparable outcomes in terms of functional outcomes in comparison to LaTME for total mesorectal excision in low rectal cancers. Having said that, LARS prevalence is still high and requires further evaluation of the technique.http://link.springer.com/article/10.1186/s12893-019-0550-4Functional outcomesFaecal incontinenceTransanal approachLow anterior resection syndromeTotal mesorectal excision |
| spellingShingle | Mateusz Rubinkiewicz Piotr Zarzycki Jan Witowski Magdalena Pisarska Natalia Gajewska Grzegorz Torbicz Michał Nowakowski Piotr Major Andrzej Budzyński Michał Pędziwiatr Functional outcomes after resections for low rectal tumors: comparison of Transanal with laparoscopic Total Mesorectal excision BMC Surgery Functional outcomes Faecal incontinence Transanal approach Low anterior resection syndrome Total mesorectal excision |
| title | Functional outcomes after resections for low rectal tumors: comparison of Transanal with laparoscopic Total Mesorectal excision |
| title_full | Functional outcomes after resections for low rectal tumors: comparison of Transanal with laparoscopic Total Mesorectal excision |
| title_fullStr | Functional outcomes after resections for low rectal tumors: comparison of Transanal with laparoscopic Total Mesorectal excision |
| title_full_unstemmed | Functional outcomes after resections for low rectal tumors: comparison of Transanal with laparoscopic Total Mesorectal excision |
| title_short | Functional outcomes after resections for low rectal tumors: comparison of Transanal with laparoscopic Total Mesorectal excision |
| title_sort | functional outcomes after resections for low rectal tumors comparison of transanal with laparoscopic total mesorectal excision |
| topic | Functional outcomes Faecal incontinence Transanal approach Low anterior resection syndrome Total mesorectal excision |
| url | http://link.springer.com/article/10.1186/s12893-019-0550-4 |
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