Functional results and quality of life after transanal total mesorectal excision

Nardi, Paola De

doi:10.20517/2574-1225.2018.30

Cited by 3 publications

(3 citation statements)

References 36 publications

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“…A wide range of data is available on the quality of life (QoL) after TaTME. Initial studies showed worse shortand mid-term functional results, but most of the subsequent studies showed comparable results between the different minimally invasive TME procedures (6)(7)(8)(9). There is no clear data that prove advantage or disadvantage of TaTME over rTME or laparoscopic TME in terms of functional results (6,(10)(11)(12).…”

Section: Introduction Introductionmentioning

confidence: 99%

Quality of Life after Transanal Total Mesorectal Excision - A Single-Center Study

Karamanliev

2023

SGO

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Introduction: Transanal total mesorectal excision (TaTME) has been used as a surgical technique for rectal cancer treatment for over a decade now. The bottom-up dissection provides a better view of the pelvic sensory nerve fibers, which theoretically could lead to better nerve preservation, hence better functional outcomes. Nevertheless, concerns about worsening of the functional results due to low anastomosis and sphincter damage caused by the platform have been raised. There is no clear data showing advantage or disadvantage of TaTME compared to robotic total mesorectal excision (rTME) or laparoscopic TME in terms of functional results. This study aims to present single-center data on quality of life (QoL) after TaTME. Material and Methods: A single-center prospective study on the quality of life after the first 16 consecutive cases of TaTME from July 2019 to June 2021 was conducted. Quality of life (QoL) was assessed with a questionnaire. A total of 13 patients were analyzed by EuroQol-5D (EQ-5D), EORTC QLQ-C30, EORTC QLQ-CR29, IPSS, LARS and Vaizey scores 1-9. Quality of Life data collection was done according to the following algorithm: (a) In patients without a stoma -preoperatively, at 3, 6, and 12 months, and annually thereafter; (b) in patients with a stoma -preoperatively, at 3 months postoperatively (if there was no stoma reversal), and after stoma reversal at 3, 6, and 12 months, and annually thereafter. All procedures were performed by the same team. Results: A total of 13 patients completed the questionnaires preoperatively and at least once postoperatively. Statistically significant improvement was found in the following parameters postoperatively compared with preoperative levels: EuroQol-5D pain/discomfort (p=0.014); physical functioning (p=0.046), financial problems (p=0.025); global health in QLQ-C30 (p=0.001), degree of anxiety/depression in QLQ-CR29 (p=0.020), specific quality of life in the IPSS questionnaire (p=0.011). No statistical differences were found in: the visual analogue self-reported health scale in EuroQol-5D (p=0.114); social functioning in the QLQ-C30 (p=0.705); fecal incontinence for patients without a stoma in QLQ-CR29 (p=0.317); degree of LARS (p=0.763); Vaziey score (p=0.782). Conclusion: quality of life after TaTME seems promising, large, well-structured trials in the scientific area are needed.

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Section: Introduction Introductionmentioning

confidence: 99%

Quality of Life after Transanal Total Mesorectal Excision - A Single-Center Study

Karamanliev

2023

SGO

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“…Given these differences, a difference in the incidence and severity of functional postoperative outcomes is possible. This is possible due to the prolonged perioperative insertion of an anal platform, sphincter-complex damage 15 and the construction of very low anastomoses with TaTME 16 . However, the majority of studies included in this meta-analysis were characterized by a large heterogeneity in important factors such as tumour height and time of follow-up 17 .…”

Section: Introductionmentioning

confidence: 99%

Transanal total mesorectal excision and low anterior resection syndrome

Heijden¹,

Qaderi²,

Verhoeven

et al. 2021

British Journal of Surgery

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Background Bowel dysfunction after rectal cancer surgery is common, with some experiencing low anterior resection syndrome (LARS) is common after rectal cancer surgery. This study examined if transanal total mesorectal excision (TaTME) has a similar risk of LARS and altered quality of life (QoL) as patients who undergo low anterior resection (LAR). Methods Patients who underwent TaTME or traditionally approached total mesorectal excision in a prospective colorectal cancer cohort study (2014–2019) were propensity score matched in a 1 : 1 ratio. LARS and QoL scores were assessed before and after surgery with a primary endpoint of major LARS at 12 months analysed for possible association between factors by logistic regression. Results Of 61 TaTME and 317 LAR patients eligible, 55 from each group were propensity score matched. Higher LARS scores (30.6 versus 25.4, P = 0.010) and more major LARS (65 versus 42 per cent, P = 0.013; OR 2.64, 95 per cent c.i. 1.22 to 5.71) were reported after TaTME. Additionally, QoL score differences (body image, bowel frequency, and embarrassment) were worse in the TaTME group. Conclusions TaTME may be associated with more severe bowel dysfunction than traditional approaches to rectal cancer.

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“…Yellinek and Wexner [4] , writing from the Cleveland clinic, discuss an alternative to the robot, namely transanal total mesorectal excision (TaTME), the importance of a registry and training programme though conclude that the single port robot may provide a method for better adopting this technique, potentially as a combined approach and ongoing trial data is awaited. De Nardi [5] suggests that TaTME has comparable functional outcomes compared with the abdominal approach though the COLOR III trial results are eagerly awaited to assess this.…”

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confidence: 99%

Preface of the special issue on "A bespoke approach to rectal cancer resection and management"

Buchanan¹

2019

MIS

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Functional results and quality of life after transanal total mesorectal excision

Cited by 3 publications

References 36 publications

Quality of Life after Transanal Total Mesorectal Excision - A Single-Center Study

Quality of Life after Transanal Total Mesorectal Excision - A Single-Center Study

Transanal total mesorectal excision and low anterior resection syndrome

Preface of the special issue on "A bespoke approach to rectal cancer resection and management"

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