A systematic review and meta-analysis of robotic-assisted transabdominal total mesorectal excision and transanal total mesorectal excision: which approach offers optimal short-term outcomes for mid-to-low rectal adenocarcinoma?

Butterworth, James; Butterworth, William; Meyer, Jérémy; Giacobino, C.; Buchs, Nicolas; Ris, Frédéric; Scarpinata, Rosaria

doi:10.1007/s10151-021-02515-7

Cited by 10 publications

(9 citation statements)

References 76 publications

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“…Both approaches aim to improve the quality of TME and secure the achievement of negative CRM. [23][24][25][26] This study showed equivalent results for several approaches, including CLS. The ROLARR trial could not show the superiority of RALS compared to CLS in regards to the rate of open conversion as a primary endpoint, as well as CRM.…”

Section: Approachsupporting

confidence: 59%

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Japanese multicenter prospective study investigating laparoscopic surgery for locally advanced rectal cancer with evaluation of CRM and TME quality (PRODUCT trial)

Takemasa

Hamabe

Ito

et al. 2022

Annals of Gastroent Surgery

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Section: Approachsupporting

confidence: 59%

“…Today, we can adopt several approaches other than CLS in the field of minimally invasive surgery, including the advancement and spread of RALS and transanal TME. Both approaches aim to improve the quality of TME and secure the achievement of negative CRM 23–26 . This study showed equivalent results for several approaches, including CLS.…”

Section: Discussionmentioning

confidence: 53%

Japanese multicenter prospective study investigating laparoscopic surgery for locally advanced rectal cancer with evaluation of CRM and TME quality (PRODUCT trial)

Takemasa

Hamabe

Ito

et al. 2022

Annals of Gastroent Surgery

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Section: Certainty Of Evidencementioning

confidence: 99%

“…A 2021 systematic review and meta-analysis of 37 studies compared taTME (n = 1326) to r-TME (n = 3835) and found similar pooled conversion rates (1.0% vs 1.2%; p = 0.91) and pathological outcomes (circumferential resection margin positivity 3.2% vs 2.7%, p = 0.22; intact mesorectal specimen 84.6% vs 90.1, p = 0.23). 113 With regard to long-term oncologic outcomes, a large meta-analysis of 30 trials including 5845 patients compared open TME (n = 2207), l-TME (n = 3072), r-TME (n = 388), and taTME (n = 178). 114 There were no statistically significant differences in DFS or LR rates between the 4 groups, and similar findings have been observed in smaller retrospective studies.…”

Section: Compared To Laparoscopic Tme (L-tme) and Robotic Tme (R-tme)...mentioning

confidence: 99%

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer 2023 Supplement

Langenfeld,

Davis,

Vogel

et al. 2023

Diseases of the Colon &Amp; Rectum

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he American Society of Colon and Rectal Surgeons (ASCRS) is dedicated to ensuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Clinical Practice Guidelines (CPG) Committee is composed of society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus and develop CPG based on the best available evidence.Although not proscriptive, these guidelines provide information on which decisions can be made and do not dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. These guidelines should not be deemed inclusive of all proper methods of care nor exclusive of methods of care reasonably directed toward obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician considering all the circumstances presented by the individual patient. STATEMENT OF THE PROBLEMColorectal cancer is the third most common cancer and the third most common cause of cancer-related deaths in the United States. 1 Approximately 30% of these cancers will originate in the rectum, and the American Cancer Society estimated a total of 44,850 new rectal cancer diagnoses in the United States for 2022. 2 Adenocarcinoma of the rectum is inherently complex. Surgery for rectal cancer is technically challenging and is associated with major alterations in GI, urinary, and sexual functions and with decreased quality of life. [3][4][5] The treatment of rectal cancer is also rapidly evolving, with new data emerging on a regular basis.In 2020, the ASCRS published its most recent CPG for rectal cancer. 6 This was a comprehensive assessment covering a wide spectrum of topics. Since then, there have been Earn continuing medical education (CME) credit online at cme.lww. com. This activity has been approved for AMA PRA category 1 credit.Funding/Support: None reported.

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“…[1] New strategies such as robotic surgery and transanal TME have been proposed to overcome this technical difficulty. [2][3][4] However, these techniques cost more and require advanced surgical skills and technological infrastructure. Therefore, the importance of forming selection criteria for difficult cases emerges.…”

Section: Introductionmentioning

confidence: 99%

Can 3D radiological calculations predict operational difficulties for rectal cancer?: A single center retrospective analysis

Yasar,

Gundogdu,

Yilmaz

et al. 2024

Medicine

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Low anterior resection, performing total mesorectal excision with appropriate pelvic dissection to prevent local recurrence, is probably the most challenging type of surgery in colorectal surgery, especially in a narrow pelvis. In this study, we aimed to predict the operation difficulty of rectal cancer by comparing the operation time with 2D and 3D pelvimetry. Sixty-six patients who underwent total mesorectal excision after neoadjuvant chemoradiotherapy due to primary rectal cancer located in the middle and lower rectum (10 cm from the anus) were included in the study. Surgery notes were reviewed and data on demographic factors, tumor stage, duration of surgery, and types of surgery were collected, as well as pelvimetric parameters. All protocols had 2D T2-weighted sequences in 3 planes (axial, sagittal, and coronal). Pelvimetric measurements were made by measuring 8 pelvic lengths and 2 angles. Pelvis and tumor volume were measured by manual margin monitoring. In each slice, both pelvis and tumor boundaries were manually drawn individually in the sagittal plane. Pelvis and tumor volumes were calculated from the set of adjacent images by summing slice thickness and products of area measurements within the pelvis and tumor boundaries. In our results, no correlation was observed with operation time, including pelvic volume. Exception for this were interacetabular distance and tumor volume. In the regression test, the only parameter that correlated with the operation time was tumor volume. In conclusion, we believe that tumor volumetric calculations may be useful in predicting difficult distal rectal carcinoma surgeries.

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A systematic review and meta-analysis of robotic-assisted transabdominal total mesorectal excision and transanal total mesorectal excision: which approach offers optimal short-term outcomes for mid-to-low rectal adenocarcinoma?

Cited by 10 publications

References 76 publications

Japanese multicenter prospective study investigating laparoscopic surgery for locally advanced rectal cancer with evaluation of CRM and TME quality (PRODUCT trial)

Japanese multicenter prospective study investigating laparoscopic surgery for locally advanced rectal cancer with evaluation of CRM and TME quality (PRODUCT trial)

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer 2023 Supplement

Can 3D radiological calculations predict operational difficulties for rectal cancer?: A single center retrospective analysis

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