Functional outcomes after resections for low rectal tumors : comparison of Transanal with laparoscopic Total Mesorectal excision
| Autor: | Piotr Major, Andrzej Budzyński, Magdalena Pisarska, Mateusz Rubinkiewicz, Michał Pędziwiatr, Natalia Gajewska, Grzegorz Torbicz, Jan Witowski, Piotr Zarzycki, Michał Nowakowski |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Operative Time lcsh:Surgery 030230 surgery Rectal Tumors Transanal approach 03 medical and health sciences Ileostomy Postoperative Complications 0302 clinical medicine medicine Humans Risk factor Adverse effect Aged Retrospective Studies Transanal Endoscopic Surgery Mesorectal Univariate analysis Proctectomy Rectal Neoplasms business.industry Incidence Faecal incontinence Recovery of Function Syndrome General Medicine Perioperative lcsh:RD1-811 Middle Aged Total mesorectal excision Functional outcomes Surgery Treatment Outcome 030220 oncology & carcinogenesis Low anterior resection syndrome Female Laparoscopy business Research Article |
| Zdroj: | BMC Surgery, Vol 19, Iss 1, Pp 1-6 (2019) BMC Surgery |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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