Comparison of transanal total mesorectal excision (TaTME) versus laparoscopic TME for rectal cancer: A case matched study

被引：13

作者：

Ye, Jingwang ^{[1
]}

Tian, Yue ^{[1
]}

Li, Fan ^{[1
]}

van Oostendorp, Stefan ^{[2
]}

Chai, Yiming ^{[3
]}

Tuynman, Jurriaan ^{[2
]}

Tong, Weidong ^{[1
]}

机构：

[1] Army Med Univ, Daping Hosp, Dept Gen Surg, Chongqing 400042, Peoples R China

[2] Vrije Univ Amsterdam, Amsterdam UMC, Canc Ctr Amsterdam, Dept Surg, Amsterdam, Netherlands

[3] Ningxia Vocat Tech Coll Ind & Commerce, Sch Liberal Arts Educ, Yinchuan, Ningxia, Peoples R China

来源：

EJSO | 2021年 / 47卷 / 05期

基金：

中国国家自然科学基金;

关键词：

Rectal cancer; Transanal TME; Laparoscopic TME; Minimal invasive surgery; SURGERY; OUTCOMES;

D O I：

10.1016/j.ejso.2020.11.131

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Transanal total mesorectal excision (TaTME) has been developed to improve the quality of laparoscopic TME for patients with rectal cancer. Recently, international concern on TaTME was raised by a national cohort study showing an increased rate of local recurrences. This study aimed to compare clinicopathological and mid-term oncological outcomes of TaTME versus laparoscopic TME (LaTME) for mid and low rectal cancer of a high volume center. Methods: From August 2014 to October 2019, patients with mid or low rectal cancer who received TaTME procedure were identified. The cases were matched with patients treated with LaTME. Data were retrospectively collected including operative details, postoperative morbidity, pathologic results, and oncologic outcomes. Primary endpoint was the local recurrence (LR) rate. Results: Propensity score matching yielded 70 patients in each of the groups. There were no statistically significant differences between the 2 groups in terms of postoperative complications, conversion rate to open surgery and circumferential resection margin. Local recurrence occurred in 2 patients (2.9%) in the transanal group, whereas 1 patient developed a local recurrence in the laparoscopic group (1.4%)(p = 0.559). KaplaneMeier survival analysis showed a 2 year Local recurrence rate 1.5% VS 1.6%(p = 0.934), DFS 88.0% VS 87.7%, OS 94.0% vs 100% for transanal and laparoscopic group, respectively. Conclusions: In a high volume center the transanal total mesorectal procedure is feasible, and appears to be safe alternative to laparoscopic surgery. Oncological outcomes were acceptable and no increased multi or unifocal local recurrence rate was found. (C) 2020 Published by Elsevier Ltd.

引用

页码：1019 / 1025

页数：7

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