Patient-reported functional and quality-of-life outcomes after transanal total mesorectal excision

Keller, Deborah S.; Reali, Claudia; Spinelli, Antonino; Penna, Marta; Candido, Francesca Di; Cunningham, Chris; Hompes, Roel

doi:10.1002/bjs.11069

Cited by 33 publications

(25 citation statements)

References 13 publications

(12 reference statements)

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“…A significant increase in LARS scores was demonstrated after surgery in all studies 33 . However, these scores returned to baseline values in the majority of studies 33,44,46 .…”

Section: Bowel Dysfunctionmentioning

confidence: 89%

Functional complaints and quality of life after transanal total mesorectal excision: a meta-analysis

Heijden

Köeter

Smits

et al. 2020

British Journal of Surgery

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Background Total mesorectal excision (TME) gives excellent oncological results in rectal cancer treatment, but patients may experience functional problems. A novel approach to performing TME is by single‐port transanal minimally invasive surgery. This systematic review evaluated the functional outcomes and quality of life after transanal and laparoscopic TME. Methods A comprehensive search in PubMed, the Cochrane Library, Embase and the trial registers was conducted in May 2019. PRISMA guidelines were used. Data for meta‐analysis were pooled using a random‐effects model. Results A total of 11 660 studies were identified, from which 14 studies and six conference abstracts involving 846 patients (599 transanal TME, 247 laparoscopic TME) were included. A substantial number of patients experienced functional problems consistent with low anterior resection syndrome (LARS). Meta‐analysis found no significant difference in major LARS between the two approaches (risk ratio 1·13, 95 per cent c.i. 0·94 to 1·35; P = 0·18). However, major heterogeneity was present in the studies together with poor reporting of functional baseline assessment. Conclusion No differences in function were observed between transanal and laparoscopic TME.

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“…A significant increase in LARS scores was demonstrated after surgery in all studies 33 . However, these scores returned to baseline values in the majority of studies 33,44,46 .…”

Section: Bowel Dysfunctionmentioning

confidence: 89%

Functional complaints and quality of life after transanal total mesorectal excision: a meta-analysis

Heijden

Köeter

Smits

et al. 2020

British Journal of Surgery

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“…This technique in IBD treatment was employed only by few expert surgeons; moreover solid data concerning long term functional outcomes are still restricted. First functional data in a series of TaTME performed for rectal cancer 37 showed preserved urinary and sexual function and low incidence and severity of LARS. De Buck van Overstraeten A. et al 13 published short-term outcomes of 97 patients from…”

Section: Discussionmentioning

confidence: 99%

Transanal Proctocolectomy And Ileal Pouch-Anal Anastomosis (TaIPAA) For Ulcerative Colitis: Medium Term Functional Outcomes In A Single Centre.

Capolupo

Carannante

Mascianà

et al. 2020

Preprint

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Background: Transanal dissection of the rectum has been recently introduced for ileal pouch-anal anastomosis (IPAA) in UC showing promising results. Thanks to the precise identification of the rectotomy site the risk of long rectal stump is avoided, and a single stapled anastomosis is performed easily.The aim of this study is to analyze our initial experience of transanal IPAA (Ta-IPAA), considering postoperative complications and medium-term functional outcomes.Methods: Our Center has experienced the transanal approach for proctectomy and IPAA since October 2018. All patients underwent Enhanced Recovery After Surgery (ERAS) protocol. Postoperative complications occurring within 30 days after surgery were taken into consideration. Fecal continence, genito-urinary activity and global quality of life at 1 and 6 months after ileostomy reversal have been assessed.Results: Until March 2019, 8 patients underwent Ta-IPAA. In all cases the laparoscopic approach was performed during the transabdominal phase; abdominal drainage was never used. At the time of the pouch construction a defunctioning loop ileostomy was created in all patients. Stoma closure was performed in all cases at a median time of 6 months after surgery. Postoperative complications occurred in only one patient, who showed rectal bleeding. There were no cases of anastomotic leakage.Medium-term functional outcomes were determined prospectively by a validated questionnaire (Cleveland Global Quality of Life). Fecal incontinence for liquid or solid stool, genitourinary and sexual functions were also investigated, showing comparable results with the literature data.Conclusions: In our experience, Ta-IPAA provided good short and medium-term functional results in UC.

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“…In the recently published work, several important lessons were learned (or further highlighted). Low anterior resection syndrome (LARS) is a widespread, global problem.…”

mentioning

confidence: 99%

“…LARS is often present, and affects patient quality of life and function, before surgery. Thus, the need for preoperative and postoperative standardized measures, as well as patient education and management of expectations is key.…”

mentioning

confidence: 99%

Correspondence

Keller

Spinelli

Hompes

2019

British Journal of Surgery

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Patient-reported functional and quality-of-life outcomes after transanal total mesorectal excision

Cited by 33 publications

References 13 publications

Functional complaints and quality of life after transanal total mesorectal excision: a meta-analysis

Functional complaints and quality of life after transanal total mesorectal excision: a meta-analysis

Transanal Proctocolectomy And Ileal Pouch-Anal Anastomosis (TaIPAA) For Ulcerative Colitis: Medium Term Functional Outcomes In A Single Centre.

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