Transanal total mesorectal excision vs intersphincteric resection for low rectal cancer: a propensity-score matching study
[Objectives] To compare the clinical effectiveness between transanal total mesorectal excision (taTME) and intersphincteric resection (ISR) for low rectal cancer. [Methods] This was a retrospective analysis of 122 patients with low rectal cancer treated at our hospital between January 2016 and April...
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Editorial Office of Journal of Colorectal & Anal Surgery
2022-02-01
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| Series: | 结直肠肛门外科 |
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| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=458&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC1%E6%9C%9F |
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| author | Li Zhengbiao Feng Qingbo Wang Xingqin Xu Fujian Wang Qi Huang Yong Xie Ming |
| author_facet | Li Zhengbiao Feng Qingbo Wang Xingqin Xu Fujian Wang Qi Huang Yong Xie Ming |
| author_sort | Li Zhengbiao |
| collection | DOAJ |
| description | [Objectives] To compare the clinical effectiveness between transanal total mesorectal excision (taTME) and intersphincteric resection (ISR) for low rectal cancer. [Methods] This was a retrospective analysis of 122 patients with low rectal cancer treated at our hospital between January 2016 and April 2021. Sixty-one patients underwent laparoscopic ISR (ISR group), and 61 underwent laparoscopic taTME (taTME group). After propensity-score matching, 38 patients were included in each group. The following data were compared between the two groups: surgical parameters, pathology findings, postoperative recovery, postoperative complications, postoperative anal function, and postoperative quality of life. [Results] All surgeries were uneventful, and there were no intraoperative complications. In the taTME group, the mesorectum was completely or nearly completely resected. The two groups did not differ significantly with regard to operation time, intraoperative blood loss, anastomosis-anus distance, protective stoma rate, distal resection margin length, positive circumferential resection margin rate, positive distal resection margin rate, and lymph node yield (P>0.05). The time to remove the catheter was significantly longer in the taTME group than in the ISR group(P<0.05). Time to the removal of drains, time to first postoperative flatulence or bowel movement, time to resuming semi-liquid diet, time to off-bed activities, postoperative hospitalization, re-admission rate within 30 days postoperative, and overall complication rate within 30 days postoperative were not significantly different between the two groups (P>0.05). The median follow-up duration was 30 months for the ISR group and 21 months for the taTME group. Wexner anal incontinence score was comparable between the two groups (P>0.05). Using the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30), the taTME group had significantly higher physical function score in the functional scales and lower diarrhea score in the single measurement scales than the ISR group (P<0.05). Using the EORTC QLQ-CR38, the ISR group had significantly higher scores of general gastrointestinal symptoms and weight loss in the symptom scales than the taTME group (P<0.05). [Conclusion] Both taTME and ISR are safe for low rectal cancer. They show comparable postoperative recovery of anal function, but taTME is associated with relatively better postoperative quality of life. |
| format | Article |
| id | doaj-art-f20130be5ee04f339a28a57a645c8315 |
| institution | Kabale University |
| issn | 1674-0491 |
| language | zho |
| publishDate | 2022-02-01 |
| publisher | Editorial Office of Journal of Colorectal & Anal Surgery |
| record_format | Article |
| series | 结直肠肛门外科 |
| spelling | doaj-art-f20130be5ee04f339a28a57a645c83152025-08-20T03:49:17ZzhoEditorial Office of Journal of Colorectal & Anal Surgery结直肠肛门外科1674-04912022-02-01281455010.19668/j.cnki.issn1674-0491.2022.01.010Transanal total mesorectal excision vs intersphincteric resection for low rectal cancer: a propensity-score matching studyLi Zhengbiao0Feng Qingbo1Wang Xingqin2Xu Fujian3Wang Qi4Huang Yong5Xie Ming6Department of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, ChinaDepartment of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, ChinaDepartment of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, ChinaDepartment of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, ChinaDepartment of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, ChinaDepartment of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, ChinaDepartment of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China[Objectives] To compare the clinical effectiveness between transanal total mesorectal excision (taTME) and intersphincteric resection (ISR) for low rectal cancer. [Methods] This was a retrospective analysis of 122 patients with low rectal cancer treated at our hospital between January 2016 and April 2021. Sixty-one patients underwent laparoscopic ISR (ISR group), and 61 underwent laparoscopic taTME (taTME group). After propensity-score matching, 38 patients were included in each group. The following data were compared between the two groups: surgical parameters, pathology findings, postoperative recovery, postoperative complications, postoperative anal function, and postoperative quality of life. [Results] All surgeries were uneventful, and there were no intraoperative complications. In the taTME group, the mesorectum was completely or nearly completely resected. The two groups did not differ significantly with regard to operation time, intraoperative blood loss, anastomosis-anus distance, protective stoma rate, distal resection margin length, positive circumferential resection margin rate, positive distal resection margin rate, and lymph node yield (P>0.05). The time to remove the catheter was significantly longer in the taTME group than in the ISR group(P<0.05). Time to the removal of drains, time to first postoperative flatulence or bowel movement, time to resuming semi-liquid diet, time to off-bed activities, postoperative hospitalization, re-admission rate within 30 days postoperative, and overall complication rate within 30 days postoperative were not significantly different between the two groups (P>0.05). The median follow-up duration was 30 months for the ISR group and 21 months for the taTME group. Wexner anal incontinence score was comparable between the two groups (P>0.05). Using the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30), the taTME group had significantly higher physical function score in the functional scales and lower diarrhea score in the single measurement scales than the ISR group (P<0.05). Using the EORTC QLQ-CR38, the ISR group had significantly higher scores of general gastrointestinal symptoms and weight loss in the symptom scales than the taTME group (P<0.05). [Conclusion] Both taTME and ISR are safe for low rectal cancer. They show comparable postoperative recovery of anal function, but taTME is associated with relatively better postoperative quality of life.https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=458&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC1%E6%9C%9Flow rectal cancertransanal total mesorectal excisionintersphincteric resection |
| spellingShingle | Li Zhengbiao Feng Qingbo Wang Xingqin Xu Fujian Wang Qi Huang Yong Xie Ming Transanal total mesorectal excision vs intersphincteric resection for low rectal cancer: a propensity-score matching study 结直肠肛门外科 low rectal cancer transanal total mesorectal excision intersphincteric resection |
| title | Transanal total mesorectal excision vs intersphincteric resection for low rectal cancer: a propensity-score matching study |
| title_full | Transanal total mesorectal excision vs intersphincteric resection for low rectal cancer: a propensity-score matching study |
| title_fullStr | Transanal total mesorectal excision vs intersphincteric resection for low rectal cancer: a propensity-score matching study |
| title_full_unstemmed | Transanal total mesorectal excision vs intersphincteric resection for low rectal cancer: a propensity-score matching study |
| title_short | Transanal total mesorectal excision vs intersphincteric resection for low rectal cancer: a propensity-score matching study |
| title_sort | transanal total mesorectal excision vs intersphincteric resection for low rectal cancer a propensity score matching study |
| topic | low rectal cancer transanal total mesorectal excision intersphincteric resection |
| url | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=458&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC1%E6%9C%9F |
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