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dc.contributor.authorLau, Steve Yee Chiang-
dc.contributor.authorChoy, Kay T-
dc.contributor.authorYang, Tze Wei Wilson-
dc.contributor.authorHeriot, Alexander-
dc.contributor.authorWarrier, Satish K-
dc.contributor.authorGuest, Glenn D-
dc.contributor.authorKong, Joseph C-
dc.identifier.citationANZ Journal of Surgery 2022; 92(3): 355-364en
dc.description.abstractTransanal total mesorectal excision (taTME) represents a novel approach to rectal dissection. Although many structured training programs have been developed worldwide to assist surgeons in implementing this new technique, the learning curve (LC) of taTME has yet to be conclusively defined. This is particularly important given the concerns regarding the complication profile and oncological safety of taTME. The aim of this review was to provide an up-to-date systematic review and meta-analysis of the LC for taTME, comparing the difference of outcomes between the LC and after learning curve (ALC) groups. An up-to-date systematic review was performed on the available literature between 2010-2020 on PubMed, EMBASE, Medline and Cochrane Library databases. All studies comparing taTME procedures before and after LC were analysed. Seven retrospective studies of prospectively collected databases were included, comparing 333 (51.0%) patients in the LC group and 320 (49.0%) patients in the ALC group. There was a significantly reduced number of adverse intra-operative events, anastomotic leaks and improved quality of mesorectal excision in the ALC group. This review shows that there is a significant improvement in clinical outcomes between the LC and ALC groups which supports the need for careful mastery and ongoing technical refinement during the LC in taTME. This procedure should be performed on a subset of carefully selected patients in the hands of experienced and well-trained teams dedicated to ongoing audit.en
dc.subjectlearning curveen
dc.subjecttransanal TMEen
dc.titleDefining the learning curve of transanal total mesorectal excision: a systematic review and meta-analysis.en
dc.typeJournal Articleen
dc.identifier.journaltitleANZ Journal of Surgeryen
dc.identifier.affiliationSir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australiaen
dc.identifier.affiliationDepartment of Surgery, University Hospital Geelong, Geelong, Victoria, Australiaen
dc.identifier.affiliationDepartment of Surgery, Epworth Geelong Hospital, Deakin University, Geelong, Victoria, Australiaen
dc.identifier.affiliationDepartment of Colorectal Surgery, Alfred Hospital, Melbourne, Victoria, Australiaen
dc.identifier.affiliationDivision of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australiaen
dc.identifier.affiliationDivision of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australiaen
dc.identifier.pubmedid34676655-, Kay T
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
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