Short- and mid-term outcomes of transanal versus laparoscopic total mesorectal excision for low rectal cancer: a meta-analysis

Jingqing Ren; Huixing Luo; Shaojie Liu; Bailin Wang; Fan Wu

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자료유형: 학술저널

저자정보: Jingqing Ren (Medical College of Jinan University) Huixing Luo (Medical College of Jinan University) Shaojie Liu (Medical College of Jinan University) Bailin Wang (Medical College of Jinan University) Fan Wu (Medical College of Jinan University)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.100 No.2

발행연도: 2021.2

수록면: 86 - 99 (14page)

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Purpose: The current meta-analysis combining mid and low rectal cancer with no meta-analysis only for low rectal cancer was seen. This meta-analysis was to compare the short- and mid-term outcomes of the transanal total mesorectal excision (TaTME) vs. laparoscopic total mesorectal excision (LaTME) for low rectal cancer.
Methods: A systematic literature search was conducted using the web-based databases; China National Knowledge Infrastructure, Chinese BioMedical Database, PubMed, Embase, Cochrane Central Register of Controlled Trials, and Wanfang Database. Randomized controlled trials (RCTs) were evaluated using the Jadad scale and non-RCTs (NRCs) were evaluated using the Newcastle-Ottawa Scale.
Results: Ten studies (2 RCTs and 8 NRCs) involving 772 patients were included. Among them, 378 patients underwent TaTME and 394 patients underwent LaTME. Compared with the LaTME group, the conversion rate was low (risk ratio [RR], 0.25; 95% confidence interval [CI], 0.11–0.54; P < 0.001), the circumferential resection margin (CRM) involvement was low (RR, 0.48; 95% CI, 0.27–0.86; P = 0.010), and the hospital stay was short (mean difference, –1.72; 95% CI, –2.89 to –0.55; P = 0.004) in the TaTME group. No significant differences were seen in the mesorectal resection quality, CRM distance, distal resection margin (DRM) involvement, DRM distance, local R1 resection, intraoperative complications, morbidity, anastomotic leakage, severe morbidity, mortality, operative time, intraoperative blood loss, harvested lymph nodes, and local recurrence rate (P > 0.05).
Conclusion: The TaTME is a promising surgical technique and is fully a safe and efficacious option in managing low rectal cancer.

#Laparoscopic surgery #Rectal cancer #Transanal endoscopic surgical procedures

참고문헌 (30)

참고문헌 신청

Tei M / 2018 / Safety and feasibility of single-port laparoscopic low anterior resection for upper rectal cancer / Am J Surg 216:1101~1106

Bademler S / 2019 / Standardized laparoscopic sphincter-preserving total mesorectal excision for rectal cancer:median of 10 years’ long-term oncologic outcome in 217 unselected consecutive patients / Surg Laparosc Endosc Percutan Tech 29:354~361

Wu Z / 2019 / Short-term outcomes of transanal versus laparoscopic total mesorectal excision: a systematic review and meta-analysis of cohort studies / J Cancer 10:341~354

Zhang X / 2019 / Short- and long-term outcomes of transanal versus laparoscopic total mesorectal excision for mid-to-low rectal cancer: a meta-analysis / Surg Endosc 33:972~985

Detering R / 2019 / Three-year nationwide experience with transanal total mesorectal excision for rectal cancer in the Netherlands: a propensity score-matched comparison with conventional laparoscopic total mesorectal excision / J Am Coll Surg 228:235~244

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