Quality of life in non-early rectal cancer treated by neoadjuvant radio-chemotherapy and endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) versus laparoscopic total mesorectal excision

D’Ambrosio, Giancarlo; Paganini, Alessandro M.; Balla, Andrea; Quaresima, Silvia; Ursi, Pietro; Bruzzone, P.; Picchetto, Andrea; Mattei, Fabrizio Ivo; Lezoche, Emanuele

doi:10.1007/s00464-015-4232-8

Cited by 29 publications

(25 citation statements)

References 48 publications

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“…We must emphasize that mesh-related erosion is a severe complication that is classified as grade III-b according to Clavien-Dindo classification [20] and almost always requires surgical treatment. This treatment of mesh-related erosion may itself cause significant functional sequelae in cases of low anterior resection, with a worsening of the patients' quality of life, especially in cases involving stoma creation [2324252627]. …”

Section: Discussionmentioning

confidence: 99%

Synthetic Versus Biological Mesh-Related Erosion After Laparoscopic Ventral Mesh Rectopexy: A Systematic Review

et al. 2017

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PurposeThis review reports the incidence of mesh-related erosion after ventral mesh rectopexy to determine whether any difference exists in the erosion rate between synthetic and biological mesh.MethodsA systematic search of the MEDLINE and the Ovid databases was conducted to identify suitable articles published between 2004 and 2015. The search strategy capture terms were laparoscopic ventral mesh rectopexy, laparoscopic anterior rectopexy, robotic ventral rectopexy, and robotic anterior rectopexy.ResultsEight studies (3,956 patients) were included in this review. Of those patients, 3,517 patients underwent laparoscopic ventral rectopexy (LVR) using synthetic mesh and 439 using biological mesh. Sixty-six erosions were observed with synthetic mesh (26 rectal, 32 vaginal, 8 recto-vaginal fistulae) and one (perineal erosion) with biological mesh. The synthetic and the biological mesh-related erosion rates were 1.87% and 0.22%, respectively. The time between rectopexy and diagnosis of mesh erosion ranged from 1.7 to 124 months. No mesh-related mortalities were reported.ConclusionThe incidence of mesh-related erosion after LVR is low and is more common after the placement of synthetic mesh. The use of biological mesh for LVR seems to be a safer option; however, large, multicenter, randomized, control trials with long follow-ups are required if a definitive answer is to be obtained.

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Section: Discussionmentioning

confidence: 99%

Synthetic Versus Biological Mesh-Related Erosion After Laparoscopic Ventral Mesh Rectopexy: A Systematic Review

et al. 2017

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“…The authors concluded that anorectal function may be worse than expected after local excision compared with TME without neoadjuvant therapy. In a longitudinal study, D'Ambrosio et al evaluated QoL among 15 patients who underwent TEM and 15 who had laparoscopic TME after CRT for clinical T2–3 rectal cancer. Although the local excision group scored better on many items at 1 and 6 months following surgery, after 1 year this group scored better only on body image, defaecation problems and weight loss.…”

Section: Discussionmentioning

confidence: 99%

“…The strengths of the present study are related to the sample size, which is larger than that in similar studies; the use of correction for multiple comparisons in the statistical analyses; the multicentre nature of the study; and the inclusion of all patients who underwent local excision, including those who subsequently had a TME after local excision. However, this study has some limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Although several studies have investigated the impact of local excision for rectal neoplasms on bowel and sexual function and on QoL, most of these studies had small sample sizes, were retrospective, comprised single‐institution experiences, included patients with benign lesions, and did not use validated questionnaires to assess functional results and QoL.…”

Section: Introductionmentioning

confidence: 99%

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Bowel function and quality of life after local excision or total mesorectal excision following chemoradiotherapy for rectal cancer

Pucciarelli

Giandomenico

Paoli

et al. 2016

British Journal of Surgery

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“…Although a nerve sparing technique is applied to laparoscopic TME, the anterior resection syndrome, including urinary dysfunctions, sexual, and variable defecation, still occurs with the rate of 50%-90% [ 49 – 52 ]. Obviously, TEM thoroughly win in this term [ 53 , 54 ]. Moreover two studies reported that there are no significant differences in QoL between TEM and TEM after NT for locally advanced rectal cancer [ 54 – 55 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of transanal endoscopic microsurgery with or without neoadjuvant therapy and standard total mesorectal excision in the treatment of clinical T2 low rectal cancer: a meta-analysis

Xu¹,

Cheng

Xiao

et al. 2017

Oncotarget

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Some clinical trials demonstrated local resection for clinical T1 rectal cancer was safe and effective. But for clinical T2 rectal cancer, the results were controversial. Neoadjuvant therapy (NT) is proven to reduce the opportunity of advanced rectal cancer recurrence in various researches. The objective of this Meta-Analysis was to evaluate the oncological outcomes of transanal endoscopic microsurgery (TEM) with or without NT comparing with conventional total mesorectal excision (TME) for the treatment of clinical T2 rectal cancer.To search for the relevant studies, an electronic search was done from the databases of Pubmed, Embase, and the Cochrane Library in this meta-analysis. We compared the effectiveness of transanal endoscopic microsurgery with or without NT and standard total mesorectal excision in the treatment of T2 Rectal Cancer. 1RCT and 3nRCTs including 121 TEM patients (TEM + NT: 59, TEM: 62) and 174 TME patients with T2 rectal cancer were retrieved. Compared with TME, there were no significant differences in the outcomes of local recurrence, overall recurrence, overall survival between TEM + NT group. However in compassion with TME, TEM without NT was associated with an increased local recurrence, overall recurrence, and a shorter overall survival, with individual ORs being 3.04 (95% Cl: 1.17–7.90; I2 = 0%), 5.67 (95% Cl: 1.58–20.38; I2 = 0%) and 0.12 (95% Cl: 0.02–0.65; I2 = 0%), respectively. Compared with TME, TEM after NT may be a feasible and safe organ preservative approach for patients with clinical T2 low rectal cancer. But for those without NT, TEM always seem be associated with worse oncological outcomes.

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Quality of life in non-early rectal cancer treated by neoadjuvant radio-chemotherapy and endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) versus laparoscopic total mesorectal excision

Cited by 29 publications

References 48 publications

Synthetic Versus Biological Mesh-Related Erosion After Laparoscopic Ventral Mesh Rectopexy: A Systematic Review

Synthetic Versus Biological Mesh-Related Erosion After Laparoscopic Ventral Mesh Rectopexy: A Systematic Review

Bowel function and quality of life after local excision or total mesorectal excision following chemoradiotherapy for rectal cancer

Comparison of transanal endoscopic microsurgery with or without neoadjuvant therapy and standard total mesorectal excision in the treatment of clinical T2 low rectal cancer: a meta-analysis

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