Comparison of transanal total mesorectal excision and robotic total mesorectal excision for low rectal cancer after neoadjuvant chemoradiotherapy
- 1 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Surgical Endoscopy
- Vol. 35 (12), 6998-7004
- https://doi.org/10.1007/s00464-020-08213-z
Abstract
Background To improve the quality of surgery for rectal cancer, both transanal total mesorectal excision (taTME) and robotic total mesorectal excision (R-TME) can be performed. However, few studies have compared outcomes of taTME and R-TME, especially for patients with low rectal cancer after undergoing neoadjuvant chemoradiation (nCRT). Thus, the objective of this study was to compare outcomes of taTME and R-TME for patients with low rectal cancer after undergoing nCRT. Methods A total of 306 consecutive patients with low rectal cancer who underwent taTME or R-TME after nCRT between 2008 and 2018 were analyzed retrospectively. Patients were classified into two groups: 1) taTME surgery group (n = 94); and 2) R-TME surgery group (n = 212). Results Clinicopathologic variables were comparable between the two groups. There was no significant difference in circumference margin involvement (1.1% in taTME vs. 2.8% in R-TME, p = 0.680) or distal resection margin (2.3 cm in taTME vs. 2.4 cm in R-TME, p = 0.629). Total operation time (239 min in taTME vs. 243 min in R-TME, p = 0.675) and major complications (including anastomosis site leakage, surgical site infection, and voiding difficulty) showed no significant difference between the two groups either. Conclusions Transanal and robotic TMEs have similar short-term outcomes for patients with rectal cancer after undergoing nCRT. High quality TME can be equally achieved with both transanal and robotic approaches.Keywords
Funding Information
- Korea Health Industry Development Institute (HI 17C1888)
This publication has 36 references indexed in Scilit:
- Transanal Total Mesorectal ExcisionAnnals of Surgery, 2017
- High Rate of Positive Circumferential Resection Margins Following Rectal Cancer SurgeryAnnals of Surgery, 2015
- Transanal Total Mesorectal Excision for Rectal Cancer: Outcomes after 140 PatientsJournal of the American College of Surgeons, 2015
- Transanal natural orifice transluminal endoscopic surgery (NOTES) rectal resection: “down-to-up” total mesorectal excision (TME)—short-term outcomes in the first 20 casesSurgical Endoscopy, 2013
- Transanal minimally invasive surgery for total mesorectal excision (TAMIS–TME): a stepwise description of the surgical technique with video demonstrationTechniques in Coloproctology, 2013
- Transanal rectosigmoid resection via natural orifice translumenal endoscopic surgery (NOTES) with total mesorectal excision in a large human cadaver seriesSurgical Endoscopy, 2012
- NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistanceSurgical Endoscopy, 2010
- Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trialThe Lancet, 2009
- RECURRENCE AND SURVIVAL AFTER TOTAL MESORECTAL EXCISION FOR RECTAL CANCERThe Lancet, 1986
- The mesorectum in rectal cancer surgery—the clue to pelvic recurrence?British Journal of Surgery, 1982