Total mesorectal excision laparoscopic versus transanal approach for rectal cancer: A systematic review and meta-analysis

Bianco, Salvatore Lo; Lanzafame, K.; Piazza, Caterina Domenica; Piazza, Vincenzo; Provenzano, Daniele; Piazza, Diego

doi:10.1016/j.amsu.2022.103260

Cited by 7 publications

(6 citation statements)

References 24 publications

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“…Its unique “downward and upward” anatomical angle avoids the “chopstick effect” resulting from space narrowing during laparoscopic surgery, particularly benign prostatic hyperplasia, pelvic narrowing, visceral fat, and/or BMI > 30 kg/m2 ( 15 ). As a current research hotspot in the field of colorectal and anal surgery, the procedure has been applied in clinical practice in many countries and a number of randomized controlled studies have been carried out ( 16 – 18 ), but variability in reported findings still precludes firm conclusions. Some studies found that TaTME was a procedure that was not inferior to laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Simple transanal total mesorectal resection versus laparoscopic transabdominal total mesorectal resection for the treatment of low rectal cancer: a single-center retrospective case-control study

Yang

Chen

et al. 2023

Front. Surg.

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AimTo evaluate the efficacy and safety of simple TaTNE in the treatment of low rectal cancer compared with laparoscopic transabdominal TME.MethodsWe collected patients with low rectal cancer admitted to our hospital between January 2019 and November 2021 who received simple TaTME or laparoscopic transabdominal TME. The main outcome was the integrity of the TME specimen. Secondary outcomes were the number of lymph nodes dissected, intraoperative blood loss, operative time, surgical conversion rate, Specimen resection length, circumferential margin (CRM), and distal resection margin (DRM), complication rate. In addition, the Wexner score and LARS score of fecal incontinence were performed in postoperative follow-up.ResultsPathological tissues were successfully resected in all patients. all circumferential margins of the specimen were negative. Specimen resection length was not statistically significant (9.94 ± 2.85 vs. 8.90 ± 2.49, P > 0.05). The incidence of postoperative complications in group A (n = 0) was significantly lower than that in group B (n = 3) (P > 0.05). There was no significant difference in operation time between group A and group B (296 ± 60.36 vs. 305 ± 58.28, P > 0.05). Among the patients with follow-up time less than 1 year, there was no significant difference in Wexner score and LARS score between group A and group B (P > 0.05). However, in patients who were followed up for more than 1 year, the Wexner score in group A (9.25 ± 2.73) was significantly lower than that in group B (17.36 ± 10.95) and was statistically significant (P < 0.05).ConclusionFor radical resection of low rectal cancer, Simple TaTME resection may be as safe and effective as laparoscopic transabdominal TME, and the long-term prognosis may be better.

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Section: Discussionmentioning

confidence: 99%

Simple transanal total mesorectal resection versus laparoscopic transabdominal total mesorectal resection for the treatment of low rectal cancer: a single-center retrospective case-control study

Yang

Chen

et al. 2023

Front. Surg.

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“…The clinical effectiveness of TaTME was primarily compared with LaTME, which reflects the current shift from the conventional open approach to the minimally invasive laparoscopic technique. 17,20,21,26,31 Overall, the evidence regarding clinical effectiveness suggests that TaTME has lower rates of conversion 21,22 and positive CRM 17,21,25 global health-related quality of life, 18-20 mortality, 18,21,22,25 postoperative complications, 18,20-22,25 and anastomotic leakage. 21,22,24 TaTME may be cost-effective compared with open TME and LaTME.…”

Section: Conclusion and Implications For Decision-or Policy-makingmentioning

confidence: 98%

Transanal Total Mesorectal Excision for Adults With Rectal Cancer

Barbara¹,

Subramonian²,

Horton³

2022

cjht

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Transanal total mesorectal excision may result in lower rates of conversion to open procedure and a better circumferential resection margin compared with laparoscopic total mesorectal excision in adults with rectal cancer. Transanal total mesorectal excision may be comparable to laparoscopic total mesorectal excision for cancer recurrence, survival, death, and short-term safety outcomes in adults with rectal cancer. Total mesorectal excision may be more cost-effective than laparoscopic and open total mesorectal excision in adults with rectal cancer, but this is uncertain.

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“…Subsequent systematic reviews, although based largely on non-randomised studies, showed similar short ( 47 ) and long term oncological, functional outcomes ( 48 – 50 ), quality of life (QoL) ( 49 ) and complications ( 47 , 50 ).…”

Section: Introductionmentioning

confidence: 99%

Innovation in gastrointestinal surgery: the evolution of minimally invasive surgery—a narrative review

Walshaw,

Huo,

McClean

et al. 2023

Front. Surg.

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BackgroundMinimally invasive (MI) surgery has revolutionised surgery, becoming the standard of care in many countries around the globe. Observed benefits over traditional open surgery include reduced pain, shorter hospital stay, and decreased recovery time. Gastrointestinal surgery in particular was an early adaptor to both laparoscopic and robotic surgery. Within this review, we provide a comprehensive overview of the evolution of minimally invasive gastrointestinal surgery and a critical outlook on the evidence surrounding its effectiveness and safety.MethodsA literature review was conducted to identify relevant articles for the topic of this review. The literature search was performed using Medical Subject Heading terms on PubMed. The methodology for evidence synthesis was in line with the four steps for narrative reviews outlined in current literature. The key words used were minimally invasive, robotic, laparoscopic colorectal, colon, rectal surgery.ConclusionThe introduction of minimally surgery has revolutionised patient care. Despite the evidence supporting this technique in gastrointestinal surgery, several controversies remain. Here we discuss some of them; the lack of high level evidence regarding the oncological outcomes of TaTME and lack of supporting evidence for robotic colorectalrectal surgery and upper GI surgery. These controversies open pathways for future research opportunities with RCTs focusing on comparing robotic to laparoscopic with different primary outcomes including ergonomics and surgeon comfort.

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Total mesorectal excision laparoscopic versus transanal approach for rectal cancer: A systematic review and meta-analysis

Cited by 7 publications

References 24 publications

Simple transanal total mesorectal resection versus laparoscopic transabdominal total mesorectal resection for the treatment of low rectal cancer: a single-center retrospective case-control study

Simple transanal total mesorectal resection versus laparoscopic transabdominal total mesorectal resection for the treatment of low rectal cancer: a single-center retrospective case-control study

Transanal Total Mesorectal Excision for Adults With Rectal Cancer

Innovation in gastrointestinal surgery: the evolution of minimally invasive surgery—a narrative review

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