Total mesorectal excision in rectal cancer management: laparoscopic or transanal?

Расулов, А. О.; Мамедли, З. З.; Джумабаев, Х. Э.; Кулушев, В. М.; Козлов, Н. А.

doi:10.17116/hirurgia2016537-44

Cited by 6 publications

(3 citation statements)

References 20 publications

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“…Four studies [ 38 – 41 ] published as thesis and not in peer-reviewed journals were excluded. One study [ 42 ] with a printing error but was repaired and one study [ 43 ] in Russian were excluded. For four studies with more than two arms, we removed the open surgery group from two studies [ 19 , 27 ] and the laparoscopic surgery plus a traditional nursing group [ 30 ] or combined two NOSES-type arms into one [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic Natural Orifice Specimen Extraction Surgery versus Conventional Surgery in Colorectal Cancer: A Meta-Analysis of Randomized Controlled Trials

Zhou

Chen

Liu

et al. 2022

Gastroenterology Research and Practice

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Objective. This study was to quantitatively synthesize data in randomized controlled trials (RCTs) of laparoscopic resection comparing natural orifice specimen extraction (NOSE) versus conventional laparoscopy (CL) in colorectal cancer. Methods. We identified eligible RCTs by searching seven electronic databases (PubMed, Cochrane Library, Embase, Web of Science, CNKI, CQVIP, Wanfang, and Sinomed). Mean differences (MDs) between groups with 95% confidence intervals (CIs) were used for continuous outcomes. Event rate ratios (RRs) were also calculated with their 95% CIs. Results. 1,569 citations were identified from electronic database as of June 2020, and finally, 21 RCTs involving 2,112 patients met the study eligibility criteria and were included. Compared to the CL group, NOSE had longer operation time (MD: 8.14 min, 95% CI: 3.02 to 13.25, and p < 0.01 ), less estimated blood loss (-10.64 ml, 95% CI: -14.92 to -6.36, and p < 0.01 ), less hospital stay after surgery (-2.21 days, 95% CI: -3.36 to -1.06, and p < 0.01 ), shorter time of gas passage after surgery (-0.58 days, 95% CI: -0.82 to -0.34, and p < 0.01 ), better pain score (-1.06, 95% CI: -3.74 to -0.37, and p < 0.01 ), and improved cosmetic scores (1.93, 95% CI: 0.77 to 3.10, p < 0.01 ). Rate ratios of total complications, infection, and incision infection all favored NOSE surgery, with RRs (95% CIs) of 0.81 (0.71 to 0.93), 0.34 (0.21 to 0.54), and 0.24 (0.12 to 0.51), respectively. Conclusion. This report appeared the first comprehensive meta-analysis of RCTs to synthesize data of laparoscopic resection with NOSE versus conventional laparoscopy. NOSE surgery seemed favorable with shorter hospital stay, less pain score, a shorter time to recover along with better cosmetic scores, and less postoperative complications.

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Section: Resultsmentioning

confidence: 99%

Laparoscopic Natural Orifice Specimen Extraction Surgery versus Conventional Surgery in Colorectal Cancer: A Meta-Analysis of Randomized Controlled Trials

Zhou

Chen

Liu

et al. 2022

Gastroenterology Research and Practice

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“…The standard neoadjuvant therapy in most parts of the world, including North America and Western Europe, is long-course CRT consists of 50-50. 4 Gy radiotherapy (RT) in 5-5.5 weeks concurrently with intravenous 5-fluorouracil (5FU) or oral capecitabine [7][8][9][10]. Since the hallmark study by Sauer et al [6] there have been many efforts to improve neoadjuvant treatment outcomes to enhance the pathological complete response (pCR) and reduce local and distant recurrence.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, the mainstay treatment for locally advanced rectal cancer (LARC) is total mesorectal excision (TME), either open or using minimally invasive methods like robotic or laparoscopic surgery [ 3 ]. Compared to the colon, the cancers of the rectum harbor distinct considerations, including the limited space to obtain sufficient margins and to dissect lateral lymph node in the true pelvis [ 3 , 4 ]. Due to these considerations, adjuvant chemoradiation (CRT) has increased the survival of rectal cancer patients and decreased the likelihood of local recurrence (LR).…”

Section: Introductionmentioning

confidence: 99%

Current approaches in intensification of long-course chemoradiotherapy in locally advanced rectal cancer: a review

et al. 2021

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Rectal cancer is one of the most prevalent cancers in the world. In many countries, the current standard of care is long-course chemoradiation (CRT), followed by total mesorectal excision. Some efforts have been made by intensifying radiation or chemotherapy components of the neoadjuvant therapy to further decrease the local recurrence and augment surgery's feasibility and improve the oncological outcomes. This paper reviews recent intensified neoadjuvant interventions in locally advanced rectal cancer (LARC) in terms of efficacy and treatment-related toxicity. Many maneuvers have been made so far to improve the oncological outcomes of rectal cancer with intensified neoadjuvant longcourse CRT. Some of these approaches seem compelling and deserve further study, while some have just increased the treatment-related toxicities without evident benefits. Those endeavors with greater pathological complete response than the standard of care may make us await the long-term results on survival rates and chronic treatment-related toxicity. After introduction of neoadjuvant CRT for LARC there have been many efforts to improve its outcomes. Here, this study gathered most of these efforts that intensified the neoadjuvant therapy with some being promising and some being futile.

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Transanale totale mesorektale Exzision – eine kritische Standortbestimmung

Holmer

Benz

Fichtner‐Feigl

et al. 2019

Chirurg

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Total mesorectal excision in rectal cancer management: laparoscopic or transanal?

Abstract: Preliminary data show comparable early outcomes after transanal and laparoscopic techniques. Laparotomy and associated compications are avoided in case of transanal extraction of specimen. Further researches are necessary to study functional and long-term results.

Cited by 6 publications

References 20 publications

Laparoscopic Natural Orifice Specimen Extraction Surgery versus Conventional Surgery in Colorectal Cancer: A Meta-Analysis of Randomized Controlled Trials

Laparoscopic Natural Orifice Specimen Extraction Surgery versus Conventional Surgery in Colorectal Cancer: A Meta-Analysis of Randomized Controlled Trials

Current approaches in intensification of long-course chemoradiotherapy in locally advanced rectal cancer: a review

Transanale totale mesorektale Exzision – eine kritische Standortbestimmung

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