Comparison of the short-term outcomes in lower rectal cancer using three different surgical techniques: Transanal total mesorectal excision (TME), laparoscopic TME, and open TME

研究成果: 雜誌貢獻文章

3 引文 (Scopus)

摘要

Background: Total mesorectal excision (TME) is the standard surgical principle in the treatment of rectal cancer. However, in recent years, there has been an increasing debate about how to obtain better results in circumferential margin (CRM) and distal margins of the surgical specimen. The CRM and distal margin involvement rates have been linked to local recurrence and disease-free survival rates. In this study, we compared three surgical techniques for the treatment of lower rectal cancer. Methods: From July 2008 to April 2018, we identified consecutive patients with lower rectal cancer who underwent TME. According to the surgical technique, we divided the patients into three groups: transanal TME (TaTME), laparoscopic TME (LaTME), and open TME (OpTME). Results: A total of 126 patients underwent TME; 39, 64 and 23 patients underwent TaTME, LaTME, and OpTME respectively. Tumor location was lower in the TaTME group than the other groups (p < 0.01). TaTME resulted in longer operation time than the other two groups (p < 0.01). In pathological outcomes, no patients with a CRM <1 mm were observed in the TaTME group compared with five (7.8%) and three patients (13.0%) with CRM <1 mm in the LaTME and OpTME group respectively (p = 0.035). Patients in the TaTME and LaTME groups also had a better disease-free survival than OpTME group (p < 0.01). Conclusion: TaTME provides surgeons with a novel and effective method to treat lower rectal cancer. In the short-term outcomes, TaTME achieved better pathological results and disease free survival than OpTME but not significantly superior to LaTME. Further studies are necessary to evaluate the long-term oncological results.
原文英語
期刊Asian Journal of Surgery
DOIs
出版狀態接受/付印 - 一月 1 2018

指紋

Rectal Neoplasms
Disease-Free Survival
Survival Rate
Recurrence
Therapeutics
Neoplasms

ASJC Scopus subject areas

  • Surgery

引用此文

@article{aa11041ef3594eec8bfb39e4fc65c582,
title = "Comparison of the short-term outcomes in lower rectal cancer using three different surgical techniques: Transanal total mesorectal excision (TME), laparoscopic TME, and open TME",
abstract = "Background: Total mesorectal excision (TME) is the standard surgical principle in the treatment of rectal cancer. However, in recent years, there has been an increasing debate about how to obtain better results in circumferential margin (CRM) and distal margins of the surgical specimen. The CRM and distal margin involvement rates have been linked to local recurrence and disease-free survival rates. In this study, we compared three surgical techniques for the treatment of lower rectal cancer. Methods: From July 2008 to April 2018, we identified consecutive patients with lower rectal cancer who underwent TME. According to the surgical technique, we divided the patients into three groups: transanal TME (TaTME), laparoscopic TME (LaTME), and open TME (OpTME). Results: A total of 126 patients underwent TME; 39, 64 and 23 patients underwent TaTME, LaTME, and OpTME respectively. Tumor location was lower in the TaTME group than the other groups (p < 0.01). TaTME resulted in longer operation time than the other two groups (p < 0.01). In pathological outcomes, no patients with a CRM <1 mm were observed in the TaTME group compared with five (7.8{\%}) and three patients (13.0{\%}) with CRM <1 mm in the LaTME and OpTME group respectively (p = 0.035). Patients in the TaTME and LaTME groups also had a better disease-free survival than OpTME group (p < 0.01). Conclusion: TaTME provides surgeons with a novel and effective method to treat lower rectal cancer. In the short-term outcomes, TaTME achieved better pathological results and disease free survival than OpTME but not significantly superior to LaTME. Further studies are necessary to evaluate the long-term oncological results.",
keywords = "Circumferential margin, Laparoscopy, Rectal cancer, Total mesorectal excision, Transanal",
author = "Chen, {Yu Ting} and Kiu, {Kee Thai} and Yen, {Min Hsuan} and Chang, {Tung Cheng}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.asjsur.2018.09.008",
language = "English",
journal = "Asian Journal of Surgery",
issn = "1015-9584",
publisher = "Elsevier Taiwan LLC",

}

TY - JOUR

T1 - Comparison of the short-term outcomes in lower rectal cancer using three different surgical techniques

T2 - Transanal total mesorectal excision (TME), laparoscopic TME, and open TME

AU - Chen, Yu Ting

AU - Kiu, Kee Thai

AU - Yen, Min Hsuan

AU - Chang, Tung Cheng

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Total mesorectal excision (TME) is the standard surgical principle in the treatment of rectal cancer. However, in recent years, there has been an increasing debate about how to obtain better results in circumferential margin (CRM) and distal margins of the surgical specimen. The CRM and distal margin involvement rates have been linked to local recurrence and disease-free survival rates. In this study, we compared three surgical techniques for the treatment of lower rectal cancer. Methods: From July 2008 to April 2018, we identified consecutive patients with lower rectal cancer who underwent TME. According to the surgical technique, we divided the patients into three groups: transanal TME (TaTME), laparoscopic TME (LaTME), and open TME (OpTME). Results: A total of 126 patients underwent TME; 39, 64 and 23 patients underwent TaTME, LaTME, and OpTME respectively. Tumor location was lower in the TaTME group than the other groups (p < 0.01). TaTME resulted in longer operation time than the other two groups (p < 0.01). In pathological outcomes, no patients with a CRM <1 mm were observed in the TaTME group compared with five (7.8%) and three patients (13.0%) with CRM <1 mm in the LaTME and OpTME group respectively (p = 0.035). Patients in the TaTME and LaTME groups also had a better disease-free survival than OpTME group (p < 0.01). Conclusion: TaTME provides surgeons with a novel and effective method to treat lower rectal cancer. In the short-term outcomes, TaTME achieved better pathological results and disease free survival than OpTME but not significantly superior to LaTME. Further studies are necessary to evaluate the long-term oncological results.

AB - Background: Total mesorectal excision (TME) is the standard surgical principle in the treatment of rectal cancer. However, in recent years, there has been an increasing debate about how to obtain better results in circumferential margin (CRM) and distal margins of the surgical specimen. The CRM and distal margin involvement rates have been linked to local recurrence and disease-free survival rates. In this study, we compared three surgical techniques for the treatment of lower rectal cancer. Methods: From July 2008 to April 2018, we identified consecutive patients with lower rectal cancer who underwent TME. According to the surgical technique, we divided the patients into three groups: transanal TME (TaTME), laparoscopic TME (LaTME), and open TME (OpTME). Results: A total of 126 patients underwent TME; 39, 64 and 23 patients underwent TaTME, LaTME, and OpTME respectively. Tumor location was lower in the TaTME group than the other groups (p < 0.01). TaTME resulted in longer operation time than the other two groups (p < 0.01). In pathological outcomes, no patients with a CRM <1 mm were observed in the TaTME group compared with five (7.8%) and three patients (13.0%) with CRM <1 mm in the LaTME and OpTME group respectively (p = 0.035). Patients in the TaTME and LaTME groups also had a better disease-free survival than OpTME group (p < 0.01). Conclusion: TaTME provides surgeons with a novel and effective method to treat lower rectal cancer. In the short-term outcomes, TaTME achieved better pathological results and disease free survival than OpTME but not significantly superior to LaTME. Further studies are necessary to evaluate the long-term oncological results.

KW - Circumferential margin

KW - Laparoscopy

KW - Rectal cancer

KW - Total mesorectal excision

KW - Transanal

UR - http://www.scopus.com/inward/record.url?scp=85054596814&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054596814&partnerID=8YFLogxK

U2 - 10.1016/j.asjsur.2018.09.008

DO - 10.1016/j.asjsur.2018.09.008

M3 - Article

AN - SCOPUS:85054596814

JO - Asian Journal of Surgery

JF - Asian Journal of Surgery

SN - 1015-9584

ER -