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Open Access 01-12-2019 | Rectal Cancer | Research article

Functional outcomes after resections for low rectal tumors: comparison of Transanal with laparoscopic Total Mesorectal excision

Authors: Mateusz Rubinkiewicz, Piotr Zarzycki, Jan Witowski, Magdalena Pisarska, Natalia Gajewska, Grzegorz Torbicz, Michał Nowakowski, Piotr Major, Andrzej Budzyński, Michał Pędziwiatr

Published in: BMC Surgery | Issue 1/2019

Abstract

Background

Aim of this study was to evaluate functional outcomes of transanal total mesorectal excision (TaTME) in comparison to conventional laparoscopic approach (LaTME) in terms of low anterior resection syndrome (LARS).

Methods

Forty-six patients who underwent total mesorectal excision for low rectal cancer between 2013 and 2017 were enrolled. Primary outcome was the severity of faecal incontinence, assessed both before the treatment and 6 months after ileostomy reversal. LARS score and Jorge-Wexner scale were utilized to analyze its severity.

Results

Twenty (87%) from TaTME and 21 (91%) from LaTME group developed LARS postoperatively. There were no significant differences between groups in terms of LARS occurrence (p = 0.63) and severity. The median Wexner score was comparable in both groups (8 [IQR: 4–12] vs 7 [3–11], p = 0.83). Univariate analysis revealed that postoperative complications were a risk factor for LARS development (p = 0.02). Perioperative outcomes, including operative time, blood loss and intraoperative adverse events did not differ significantly between groups either. Five TaTME patients developed postoperative complications, while there were morbidity 6 cases in LaTME group. Quality of mesorectal excision was comparable with 20 and 19 complete cases in TaTME and LaTME groups, respectively.

Conclusions

TaTME provided comparable outcomes in terms of functional outcomes in comparison to LaTME for total mesorectal excision in low rectal cancers. Having said that, LARS prevalence is still high and requires further evaluation of the technique.

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Title: Functional outcomes after resections for low rectal tumors: comparison of Transanal with laparoscopic Total Mesorectal excision
Authors: Mateusz Rubinkiewicz
Piotr Zarzycki
Jan Witowski
Magdalena Pisarska
Natalia Gajewska
Grzegorz Torbicz
Michał Nowakowski
Piotr Major
Andrzej Budzyński
Michał Pędziwiatr
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Rectal Cancer
Rectal Cancer
Ileostomy
Published in: BMC Surgery / Issue 1/2019
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-019-0550-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Functional outcomes after resections for low rectal tumors: comparison of Transanal with laparoscopic Total Mesorectal excision

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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