Transanal total mesorectal excision: short- and long-term results of four certified colorectal cancer centers in Germany.

Autor: Grundler E; Klinik für Allgemein-, Viszeral-, Thoraxchirurgie und Adipositasmedizin, Caritas Krankenhaus St. Josef Regensburg, Landshuter Str. 65, 93053, Regensburg, Germany., Gerken M; Tumor Center Regensburg - Center for Quality Management and Health Services Research, University of Regensburg, Regensburg, Germany., Schatz S; Klinik für Allgemein-, Viszeral-, Thoraxchirurgie und Adipositasmedizin, Caritas Krankenhaus St. Josef Regensburg, Landshuter Str. 65, 93053, Regensburg, Germany., Dittrich L; Chirurgische Klinik, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum Und Campus Mitte, Augustenburger Platz 1, 13353, Berlin, Germany., Biebl M; Chirurgische Klinik, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum Und Campus Mitte, Augustenburger Platz 1, 13353, Berlin, Germany.; Abteilung für Allgemeine Chirurgie, Viszeral-, Thorax-, Gefäß- und Transplantationschirurgie, Ordensklinikum Linz, Fadingerstraße 1, 4020, Linz, Austria., Rink AD; Klinik für Allgemein-, Viszeral-, Gefäß- und Transplantationschirurgie, Sektion Minimalinvasive Onkologische Chirurgie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Germany.; Klinik für Allgemeinchirurgie, Visceral- und Thoraxchirurgie, Klinikum Leverkusen, Am Gesundheitspark 11, 51375, Leverkusen, Germany., Kneist W; Klinik für Allgemein-, Viszeral-, und Transplantationschirurgie, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.; Chirurgische Klinik I - Allgemein-, Viszeral- und Thoraxchirurgie, Klinikum Darmstadt, Grafenstraße 9, 64283, Darmstadt, Germany., Aigner F; Chirurgische Klinik, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum Und Campus Mitte, Augustenburger Platz 1, 13353, Berlin, Germany.; Krankenhaus der Barmherzigen Brüder Graz, Chirurgische Abteilung, Marschallgasse 12, 8020, Graz, Austria., Völkel V; Tumor Center Regensburg - Center for Quality Management and Health Services Research, University of Regensburg, Regensburg, Germany., Fürst A; Klinik für Allgemein-, Viszeral-, Thoraxchirurgie und Adipositasmedizin, Caritas Krankenhaus St. Josef Regensburg, Landshuter Str. 65, 93053, Regensburg, Germany. afuerst@csj.de.
Jazyk: angličtina
Zdroj: International journal of colorectal disease [Int J Colorectal Dis] 2024 Aug 15; Vol. 39 (1), pp. 132. Date of Electronic Publication: 2024 Aug 15.
DOI: 10.1007/s00384-024-04704-w
Abstrakt: Background: Transanal total mesorectal excision (TaTME), a novel approach for treating low rectal cancer, holds promise. However, concerns exist in certain countries about their oncologic safety due to less-than-optimal outcomes on global studies. This research seeks to evaluate the long-term oncologic outcomes focusing on local recurrence rate and overall survival after TaTME surgery in Germany.
Patients and Methods: This study analyzed data from patients who underwent elective TaTME surgery between 2014 and 2021 in four certified colorectal cancer centers in Germany. Primary endpoints were 3-year local recurrence rate and local recurrence-free survival (LRFS). Secondary outcomes encompassed overall survival (OS), operative time, completeness of local tumor resection, lymph node resection, and postoperative complications.
Results: A total of 378 patients were analyzed (mean age 61.6 years; 272 males, 72%). After a median follow-up period of 2.5 years, 326 patients with UICC-stages I-III and tumor operability included in survival analyses. Local recurrence was observed in 8 individuals, leading to a 3-year cumulative local recurrence rate of 2.2% and a 3-year LRFS rate of 88.1%. The 3-year OS rate stood at 88.9%. Within 30 days after surgery, anastomotic leakage occurred in 19 cases (5%), whereas a presacral abscess was present in 12 patients (3.2%).
Conclusion: TaTME proves effective in addressing the anatomical and technical challenges of low rectal surgery and is associated with pleasing short- and long-term results. However, its safe integration into surgical routine necessitates sufficient knowledge and a previously completed training program.
(© 2024. The Author(s).)
Databáze: MEDLINE
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