Early Experience With Transanal Total Mesorectal Excision Compared With Laparoscopic Total Mesorectal Excision for Rectal Cancer: A Propensity Score-Matched Analysis
BACKGROUND:
Laparoscopic total mesorectal excision is widely used for rectal cancers; however, it is sometimes challenging, especially in obese patients with low tumors, particularly after chemoradiotherapy. Transanal total mesorectal excision was developed to overcome these limitations in terms of visualization, dissection, and stapling.
OBJECTIVE:
The purpose of this study was to compare the pathologic and early oncologic outcomes of the laparoscopic and transanal approaches.
DESIGN:
This was a retrospective comparative study using propensity score–matched analysis.
SETTING:
The study was conducted at a tertiary hospital specializing in oncology.
PATIENTS:
In total, 722 inpatients who underwent total mesorectal excision for rectal cancer from January 2014 to December 2017 were included.
INTERVENTIONS:
Laparoscopic (N = 514) and transanal (N = 208) total mesorectal excision were performed.
MAIN OUTCOME MEASURES:
The primary outcome was pathologic outcome including circumferential and distal resection margin involvement. The secondary outcomes were intraoperative and postoperative complications and overall survival, recurrence-free survival, and local recurrence rates.
RESULTS:
The 2 groups of the cohort had several differences; thus, we performed propensity score matching. The circumferential resection margin was involved in 13.4% and 12.9% of the laparoscopic and transanal groups (p = 0.88). The distal resection margin was involved in 1% and 3% of t...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Colorectal Cancer Source Type: research
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