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Title: Comparing functional outcomes between transanal total mesorectal excision (TaTME) and laparoscopic total mesorectal excision (LaTME) for rectal cancer: a systematic review and meta-analysis.
Austin Authors: Choy, Kay T ;Yang, Tze Wei Wilson;Prabhakaran, Swetha;Heriot, Alexander;Kong, Joseph C;Warrier, Satish K
Affiliation: Surgery
Division of Cancer Surgery, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria, 3000, Australia
Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
Department of Colorectal Surgery, Alfred Hospital, Melbourne, Victoria, Australia
Issue Date: Jun-2021 2021-02-13
Publication information: International Journal of Colorectal Disease 2021; 36(6): 1163-1174
Abstract: There is concern that transanal total mesorectal excision (TaTME) may result in poorer functional outcomes as compared to laparoscopic TME (LaTME). These concerns arise from the fact that TaTME entails both a low anastomosis and prolonged dilatation of the anal sphincter from the transanal platform. This paper aimed to assess the comparative functional outcomes following TaTME and LaTME, with a focus on anorectal and genitourinary outcomes. A meta-analysis and systematic review was performed on available literature between 2000 and 2020 from the PubMed, EMBASE, Medline, and Cochrane Library databases. All comparative studies assessing the functional outcomes following taTME versus LaTME in adults were included. Functional anorectal and genitourinary outcomes were evaluated using validated scoring systems. A total of seven studies were included, consisting of one randomised controlled trial and six non-randomised studies. There were 242 (52.0%) and 233 (48.0%) patients in the TaTME and LaTME groups respectively. Anorectal functional outcomes were similar in both groups with regard to LARS scores (30.6 in the TaTME group and 28.3 in the LaTME group), Jorge-Wexner incontinence scores, and EORTC QLQ C30/29 scores. Genitourinary function was similar in both groups with IPSS scores of 5.5 to 8.0 in the TaTME group, and 3.5 to 10.1 in the LaTME group. (pā€‰=ā€‰0.835). This review corroborates findings from previous studies in showing that the transanal approach is not associated with increased anal sphincter damage. Further prospective clinical trials are needed in this field of research.
DOI: 10.1007/s00384-021-03849-2
ORCID: 0000-0002-1392-2480
Journal: International Journal of Colorectal Disease
PubMed URL: 33580808
Type: Journal Article
Subjects: Functional outcomes
Laparoscopic TME
Scoring system
Transanal TME
Appears in Collections:Journal articles

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