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Transanal total mesorectal excision for rectal cancer: a multicentric cohort study

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单位: [1]Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangzhou, Guangdong, P. R. China [2]Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P. R. China [3]Department of General Surgery, Dongguan Kanghua Hospital, Dongguan, Guangdong, P. R. China [4]Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China [5]Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P. R. China [6]Department of General Surgery, Beijing Friendship Hospital, Beijing, P. R. China [7]Department of Colorectal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P. R. China [8]Department of General Surgery, Peking University Third Hospital, Beijing, P. R. China [9]Department of Gastrointestinal Surgery, Daping Hospital, Third Military Medical University, Chongqing, P. R. China [10]Department of Gastrointestinal Surgery, Peking University People’s Hospital, Beijing, P. R. China [11]Department of General Surgery, Chongqing Three Gorges Center Hospital, Chongqing, P. R. China
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关键词: rectal cancer laparoscopic transanal total mesorectal excision multicentric

摘要:
Background: Transanal total mesorectal excision (taTME) has recently emerged as a promising novel surgical procedure for rectal cancer. It is believed to hold the potential advantage of providing better access to mobilize the distal rectum and achieving better pathologic results. This study aimed to evaluate the feasibility of taTME for rectal cancer and summarize the preliminary experience in 10 Chinese hospitals. Methods: A total of 211 patients were enrolled in this study. Variables for evaluation of safety, feasibility, and oncologic outcomes were retrospectively collected and analysed. Results: The median distance between the tumor and the anal verge was 5.9 cm (range, 1.5-12 cm). The median operating time was 280 min (range, 70-600 min) and the median estimated intra-operative blood loss was 50 mL (range, 10-1,500 mL). The overall rate of complication was 27.9%. Among the 211 patients, 175 (82.9%) had complete TME and 33 (15.6%) had near complete TME. The circumferential resection margin was negative in 97.7% of patients. The patients were followed for a median of 35 months (range, 2-86 months). There was 7.6% (16) mortality, 6.2% (13) had local recurrence, and 12.8% (27) had systemic recurrence. Kaplan-Meier survival analysis showed that 1-, 2-, and 3-year disease-free survival rates were 94.8%, 89.3%, and 80.2%, respectively, and 1-, 2-, and 3-year OS rates were 97.4%, 95.7%, and 92.9%, respectively. Conclusions: Although limited by its retrospective nature, taTME was safe and feasible in selected patients. Future work with rigorous data recording is warranted.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 4 区 胃肠肝病学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 胃肠肝病学
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出版当年[2018]版:
Q3 GASTROENTEROLOGY & HEPATOLOGY
最新[2023]版:
Q2 GASTROENTEROLOGY & HEPATOLOGY

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2018版] 出版当年五年平均[2014-2018] 出版前一年[2017版] 出版后一年[2019版]

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第一作者单位: [1]Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangzhou, Guangdong, P. R. China
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通讯机构: [1]Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangzhou, Guangdong, P. R. China [5]Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P. R. China [6]Department of General Surgery, Beijing Friendship Hospital, Beijing, P. R. China [*1]Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. No. 1 Wangfujing, Shuaifuyuan Hutong, Dongcheng, Beijing 100730, P. R. China [*2]Department of General Surgery, Beijing Friendship Hospital. No. 95 Yongan Road, Xicheng, Beijing 100050, P. R. China [*3]Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, No. 26, Yuancun Erheng Road, Tianhe, Guangzhou, Guangdong 510655, P. R. China
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