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Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands

PURPOSE: Transanal total mesorectal excision (TaTME) was developed to overcome surgical difficulties experienced in distal pelvic dissection. Concerns have been raised about potential worse postoperative functional outcomes after TaTME. Also, the oncological safety was questioned. This study aimed t...

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Autores principales: van der Heijden, Joost A.G., van de Pas, Kelly G.H., van den Broek, Frank J.C., van Dielen, Francois M.H., Slooter, Gerrit D., Maaskant-Braat, Adriana J.G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Coloproctology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8898637/
https://www.ncbi.nlm.nih.gov/pubmed/34182715
http://dx.doi.org/10.3393/ac.2020.00773.0110
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author van der Heijden, Joost A.G.
van de Pas, Kelly G.H.
van den Broek, Frank J.C.
van Dielen, Francois M.H.
Slooter, Gerrit D.
Maaskant-Braat, Adriana J.G.
author_facet van der Heijden, Joost A.G.
van de Pas, Kelly G.H.
van den Broek, Frank J.C.
van Dielen, Francois M.H.
Slooter, Gerrit D.
Maaskant-Braat, Adriana J.G.
author_sort van der Heijden, Joost A.G.
collection PubMed
description PURPOSE: Transanal total mesorectal excision (TaTME) was developed to overcome surgical difficulties experienced in distal pelvic dissection. Concerns have been raised about potential worse postoperative functional outcomes after TaTME. Also, the oncological safety was questioned. This study aimed to describe the functional, surgical, oncological outcomes and quality of life (QoL) after TaTME. METHODS: All consecutive TaTME cases for rectal cancer without disseminated disease between December 2016 and April 2019 were included. The Wexner incontinence score, low anterior resection syndrome (LARS) score, fecal incontinence-related QoL, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-core questionnaire and 29-item module (EORTC QLQ-C30/CR29) were collected. Kaplan-Meier analysis was used to calculate local recurrence-free survival. RESULTS: Thirty patients were eligible for analysis of which 23 received questionnaires. Response rate was 74%. After a median follow-up of respectively 20.0 and 23.0 months for functional and oncological outcomes, the median (interquartile range) of Wexner incontinence and LARS scores were 9.0 (7.0–12.0) and 33.1 (25.0–39.0). Major LARS was present in 73.3%. Fecal incontinence, general and colorectal-specific QoL subdomains that are associated with poor bowel function scored in line with previously reported data. The 2-year actuarial cumulative local recurrence rate was 3.7% (95% confidence interval, 2.4%–5.0%). CONCLUSION: TaTME may lead to significant functional impairments. Patients should receive preoperative counseling on this topic and be fully aware of the potential consequences of their treatment. Oncological data were in line with other short- to moderate-term data and did not show alarming results.
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spelling pubmed-88986372022-03-11 Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands van der Heijden, Joost A.G. van de Pas, Kelly G.H. van den Broek, Frank J.C. van Dielen, Francois M.H. Slooter, Gerrit D. Maaskant-Braat, Adriana J.G. Ann Coloproctol Original Article PURPOSE: Transanal total mesorectal excision (TaTME) was developed to overcome surgical difficulties experienced in distal pelvic dissection. Concerns have been raised about potential worse postoperative functional outcomes after TaTME. Also, the oncological safety was questioned. This study aimed to describe the functional, surgical, oncological outcomes and quality of life (QoL) after TaTME. METHODS: All consecutive TaTME cases for rectal cancer without disseminated disease between December 2016 and April 2019 were included. The Wexner incontinence score, low anterior resection syndrome (LARS) score, fecal incontinence-related QoL, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-core questionnaire and 29-item module (EORTC QLQ-C30/CR29) were collected. Kaplan-Meier analysis was used to calculate local recurrence-free survival. RESULTS: Thirty patients were eligible for analysis of which 23 received questionnaires. Response rate was 74%. After a median follow-up of respectively 20.0 and 23.0 months for functional and oncological outcomes, the median (interquartile range) of Wexner incontinence and LARS scores were 9.0 (7.0–12.0) and 33.1 (25.0–39.0). Major LARS was present in 73.3%. Fecal incontinence, general and colorectal-specific QoL subdomains that are associated with poor bowel function scored in line with previously reported data. The 2-year actuarial cumulative local recurrence rate was 3.7% (95% confidence interval, 2.4%–5.0%). CONCLUSION: TaTME may lead to significant functional impairments. Patients should receive preoperative counseling on this topic and be fully aware of the potential consequences of their treatment. Oncological data were in line with other short- to moderate-term data and did not show alarming results. Korean Society of Coloproctology 2022-02 2021-06-29 /pmc/articles/PMC8898637/ /pubmed/34182715 http://dx.doi.org/10.3393/ac.2020.00773.0110 Text en Copyright © 2022 The Korean Society of Coloproctology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
van der Heijden, Joost A.G.
van de Pas, Kelly G.H.
van den Broek, Frank J.C.
van Dielen, Francois M.H.
Slooter, Gerrit D.
Maaskant-Braat, Adriana J.G.
Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands
title Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands
title_full Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands
title_fullStr Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands
title_full_unstemmed Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands
title_short Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands
title_sort oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the netherlands
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8898637/
https://www.ncbi.nlm.nih.gov/pubmed/34182715
http://dx.doi.org/10.3393/ac.2020.00773.0110
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