دورية أكاديمية
An international multicentre prospective audit of elective rectal cancer surgery; operative approach versus outcome, including transanal total mesorectal excision (TaTME)
| العنوان: | An international multicentre prospective audit of elective rectal cancer surgery; operative approach versus outcome, including transanal total mesorectal excision (TaTME) |
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| المؤلفون: | R. Tutino, G. salamone, L. Licari, G. Cocorullo, G. Gulotta |
| المساهمون: | R. Tutino, G. salamone, L. Licari, G. Cocorullo, G. Gulotta |
| بيانات النشر: | Blackwell Publishing Ltd |
| سنة النشر: | 2018 |
| المجموعة: | IRIS Università degli Studi di Palermo |
| مصطلحات موضوعية: | laparoscopic surgery, Rectal cancer, robotic surgery, TaTME, TME, transanal TME, Gastroenterology |
| الوصف: | Introduction: Transanal total mesorectal excision (TaTME) has rapidly emerged as a novel approach for rectal cancer surgery. Safety profiles are still emerging and more comparative data is urgently needed. This study aimed to compare indications and short-term outcomes of TaTME, open, laparoscopic, and robotic TME internationally. Methods: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients undergoing elective total mesorectal excision (TME) for malignancy between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak. Results: Of 2579 included patients, 76.2% (1966/2579) underwent TME with restorative anastomosis of which 19.9% (312/1966) had a minimally invasive approach (laparoscopic or robotic) which included a transanal component (TaTME). Overall, 9.0% (175/1951, 15 missing outcome data) of patients suffered an anastomotic leak. On univariate analysis both laparoscopic TaTME (OR 1.61, 1.02–2.48, P = 0.04) and robotic TaTME (OR 3.05, 1.10–7.34, P = 0.02) were associated with a higher risk of anastomotic leak than non-transanal laparoscopic TME. However this association was lost in the mixed-effects model controlling for patient and disease factors (OR 1.23, 0.77–1.97, P = 0.39 and OR 2.11, 0.79–5.62, P = 0.14 respectively), whilst low rectal anastomosis (OR 2.72, 1.55–4.77, P < 0.001) and male gender (OR 2.29, 1.52–3.44, P < 0.001) remained strongly associated. The overall positive circumferential margin resection rate was 4.0%, which varied between operative approaches: laparoscopic 3.2%, transanal 3.8%, open 4.7%, robotic 1%. Conclusion: This contemporaneous international snapshot shows that uptake of the TaTME approach is widespread and is associated with surgically and pathologically acceptable results. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/30255642; info:eu-repo/semantics/altIdentifier/wos/WOS:000445602400006; volume:20; issue:Suppl 6; firstpage:33; lastpage:46; numberofpages:14; journal:COLORECTAL DISEASE; http://hdl.handle.net/10447/303523Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85053850955 |
| DOI: | 10.1111/codi.14376 |
| الإتاحة: | https://doi.org/10.1111/codi.14376Test http://hdl.handle.net/10447/303523Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.E58DE659 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1111/codi.14376 |
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