A prospective study of health related quality of life, bowel and sexual function after TaTME and conventional laparoscopic TME for mid and low rectal cancer

Li, Y; Bai, Xueshan; Niu, Beizhan; Zhou, Jiaolin; Qiu, Huizhong; Xiao, Yi; Lin, Guole

doi:10.1007/s10151-020-02397-1

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…We included 14 studies [14,15,19,21–23,25–27,31–34] about circumferential resection margin. Compared with TaTME, patients who underwent LaTME had no statistical difference (RR 1.18; 95% CI: 0.86–1.61; I 2 = 0%, P = .304) (Fig.…”

Section: Resultsmentioning

confidence: 99%

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Laparoscopic total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer: A systematic review and meta-analysis

Yi Chi,

Gang,

Xiao Li

et al. 2024

Medicine

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Background: Laparoscopic total mesorectal excision (LaTME) and transanal total mesorectal excision (TaTME) are popular mid and low rectal cancer trends. However, there is currently no systematic comparison between LaTME and TaTME of mid and low rectal cancer. Therefore, we systematically study the perioperative and pathological outcomes of LaTME and TaTME in mid and low rectal cancer. Methods: Articles included searching through the Embase, Cochrane Library, PubMed, Medline, and Web of science for articles on LaTME and TaTME. We calculated pooled standard mean difference (SMD), relative risk (RR), and 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42022380067). Results: There are 8761 participants included in 33 articles. Compared with TaTME, patients who underwent LaTME had no statistical difference in operation time (OP), estimated blood loss (EBL), postoperative hospital stay, over complications, intraoperative complications, postoperative complications, anastomotic stenosis, wound infection, circumferential resection margin, distal resection margin, major low anterior resection syndrom, lymph node yield, loop ileostomy, and diverting ileostomy. There are similarities between LaTME and TaTME for 2-year DFS rate, 2-year OS rate, distant metastasis rat, and local recurrence rate. However, patients who underwent LaTME had less anastomotic leak rates (RR 0.82; 95% CI: 0.70–0.97; I 2 = 10.6%, P = .019) but TaTME had less end colostomy (RR 1.96; 95% CI: 1.19–3.23; I 2 = 0%, P = .008). Conclusion: This study comprehensively and systematically evaluated the differences in safety and effectiveness between LaTME and TaTME in the treatment of mid and low rectal cancer through meta-analysis. Patients who underwent LaTME had less anastomotic leak rate but TaTME had less end colostomy. There is no difference in other aspects. Of course, in the future, more scientific and rigorous conclusions need to be drawn from multi-center RCT research.

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Section: Resultsmentioning

confidence: 99%

“…We included 15 studies [8,9,12,14,15,20,21,23,[25][26][27][28][29][30][31] about over complications. Compared with TaTME, patients who underwent LaTME had no statistical difference (RR 0.96; 95% CI: 0.86-1.07; I 2 = 32.1%, P = .418) (Fig.…”

Section: Perioperative Outcomesmentioning

confidence: 99%

Laparoscopic total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer: A systematic review and meta-analysis

Yi Chi,

Gang,

Xiao Li

et al. 2024

Medicine

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“…A multicenter observational study [ 32 ] reported that the robotic approach may be superior in preserving postoperative anorectal function when compared with TaTME. However, this result may be influenced by the difference in the proportion of patients who underwent neoadjuvant chmeoradiotherapy among the groups analyzed.…”

Section: Discussionmentioning

confidence: 99%

Functional outcomes after transanal total mesorectal excision (TaTME): a random forest analysis to predict patients’ outcomes

et al. 2023

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Purpose Anorectal, sexual, and urinary dysfunction are common issues after rectal cancer surgery, although seldom explored. The primary aim of this study was to investigate postoperative anorectal functional results. Methods Patients with mid/low-rectal cancer treated with transanal TME (TaTME) with primary anastomosis with/without diverting stoma between 2015 and 2020 were reviewed and selected if they had a minimum follow-up of 6 months (from the primary procedure or stoma reversal). Patients were interviewed using validated questionnaires and the primary outcome was bowel function based on Low Anterior Resection Syndrome (LARS) scores. Statistical analyses were performed to identify clinical/operative variables correlated with worse outcomes. A random forest (RF) algorithm was computed to classify patients at a greater risk of minor/major LARS. Results Ninety-seven patients were selected out of 154 TaTME performed. Overall, 88.7% of the patients had a protective stoma and 25.8% reported major LARS at mean follow-up of 19.0 months. Statistical analyses documented that age, operative time, and interval to stoma reversal correlated with LARS outcomes. The RF analysis disclosed worse LARS symptoms in patients with longer operative time (> 295 min) and stoma reversal interval (> 5.6 months). If the interval ranged between 3 and 5.6 months, older patients (> 65 years) reported worse outcomes. Finally, no statistical difference was documented when comparing the rate of minor/major LARS in the first 27 cases versus others. Conclusion One-quarter of the patients developed major LARS after TaTME. An algorithm based on clinical/operative variables, such as age, operative time, and time to stoma reversal, was developed to identify categories at risk for LARS symptoms.

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“…An important factor that significantly reduces the quality of a patient’s sex life is the necessity to create a stoma [ 19 , 20 , 33 , 63 , 92 , 93 ]. The surgical procedure affects the quality of sex life to varying degrees, depending on the surgical treatment method chosen [ 28 , 37 , 38 , 44 , 68 , 84 , 96 , 97 , 98 , 99 ].…”

Section: Discussionmentioning

confidence: 99%

“…Males are more often negatively affected by the surgery. However, it has been proven that some surgical approaches have less of an impact on sexual functioning [ 20 , 28 , 37 , 38 , 44 , 68 , 84 , 96 , 97 , 98 , 99 ]. Taking female sexual functions into account, there is a report of them decreasing over time.…”

Section: Methodsmentioning

confidence: 99%

The Quality of Life of Patients with Surgically Treated Colorectal Cancer: A Narrative Review

Świątkowski

Górnicki

Bułdyś

et al. 2022

JCM

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Introduction. Quality of life is a topic increasingly being addressed by researchers. Due to the increasing incidence of colorectal cancer, this issue is particularly relevant. Despite the increasing number of publications on this topic each year, it still requires further research. The aim of this study was to analyze the available literature from the past 10 years, addressing the topic of QoL in patients with colorectal cancer which has been treated surgically. Material and methods. This review is based on 93 articles published between 2012 and 2022. It analyzes the impact of socioeconomic factors, the location and stage of the tumor, stoma and the method of surgical treatment on patients’ QoL and sexual functioning. Results. CRC has a negative impact on patients’ financial status, social functioning, pain and physical functioning. Patients with stage II or III cancer have an overall lower QoL than patients with stage I. The more proximally the lesion is located to the sphincters, the greater the negative impact on the QoL. There was a significant difference in favor of laparoscopic surgery compared with open surgery. In patients with a stoma, the QoL is lower compared with patients with preserved gastrointestinal tract continuity. The more time has passed since surgery, the more the presence of a stoma has a negative impact on QoL. Surgery for CRC negatively affects patients’ sex lives, especially in younger people and among men. Conclusions. This study may contribute to the identification of the factors that affect the QoL of patients with surgically treated colorectal cancer. This will allow even more effective and complete treatment, facilitating patients’ return to normal physical, mental and social functioning.

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A prospective study of health related quality of life, bowel and sexual function after TaTME and conventional laparoscopic TME for mid and low rectal cancer

Cited by 9 publications

References 33 publications

Laparoscopic total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer: A systematic review and meta-analysis

Laparoscopic total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer: A systematic review and meta-analysis

Functional outcomes after transanal total mesorectal excision (TaTME): a random forest analysis to predict patients’ outcomes

The Quality of Life of Patients with Surgically Treated Colorectal Cancer: A Narrative Review

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