Mid-term oncological outcomes of transanal total mesorectal excision for rectal cancer: a prospective, single center, randomized controlled trial
[Objectives] To compare mid-term oncological outcomes between transanal total mesorectal excision (taTME) and laparoscopic total mesorectal excision (lapTME) for rectal cancer. [Methods] This was a prospective randomized controlled trial of 68 patients with mid-and low rectal cancer admitted to the...
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| Language: | zho |
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Editorial Office of Journal of Colorectal & Anal Surgery
2022-12-01
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| Series: | 结直肠肛门外科 |
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| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=322&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC6%E6%9C%9F |
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| author | Zhu Yongfei Yang Xuanhua Teng Qing Guo Qing Fu Zhiyong Fan Yushi Huang Haixia Jing Rong Zhou Dongbing Qin Long Li Quanlin Tian Yunhong Kang Liang Ren Mingyang |
| author_facet | Zhu Yongfei Yang Xuanhua Teng Qing Guo Qing Fu Zhiyong Fan Yushi Huang Haixia Jing Rong Zhou Dongbing Qin Long Li Quanlin Tian Yunhong Kang Liang Ren Mingyang |
| author_sort | Zhu Yongfei |
| collection | DOAJ |
| description | [Objectives] To compare mid-term oncological outcomes between transanal total mesorectal excision (taTME) and laparoscopic total mesorectal excision (lapTME) for rectal cancer. [Methods] This was a prospective randomized controlled trial of 68 patients with mid-and low rectal cancer admitted to the Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College for planned radical surgery between December 2018 and April 2021. Patients were randomly assigned to the taTME group (n=33) and the lapTME group (n=35) using a random number table. One patient in the lapTME group was found during exploration to have peritoneal metastasis and excluded. The final study included 33 patients in the taTME group and 34 patients in the lapTME group. Pathology and follow-up data were collected and analyzed. Primary endpoints included two-year overall survival (OS), two-year disease-free survival (DFS), local recurrence, distant metastasis, and death. Secondary endpoint was pathology findings. [Results] No patients in either group showed positive distal resection margin or positive circumferential resection margin. The two groups did not differ significantly in terms of length of specimen, tumor length, distance between proximal and distal resection margin, distance between circumferential resection margin, grade of mesangial integrity, lymph node yield, T stage, N stage, and TNM stage (P>0.05). No patients were lost to follow-up. The Median follow-up was 31 (12, 40) months. Up to April 2022, no patients had local recurrence. One patient in the taTME group (3.0%) and one in the lapTME group (2.9%) was found to have lung metastasis at 18 and 19 months after surgery, respectively. No liver or other distant metastasis was reported. One patient in the taTME group died due to multiorgan failure caused by postoperative lung infection; one patient in the lapTME group had sudden death due to cardiac arrest at 1 month after surgery; no further death was reported during the follow-up period. The overall mortality rate was 3.0% in the taTME group and 2.9% in the lapTME group (P=1.000). Two-year OS was 97.0% in the taTME group and 97.1% in the lapTME group (P=0.986). Two-year DFS was 93.9% in the taTME group and 94.1% in the lapTME group (P=0.974). [Conclusion] TaTME is a safe and feasible treatment option for mid-and low rectal cancer. It can achieve comparable effectiveness and satisfactory mid-term oncological outcomes as lapTME. |
| format | Article |
| id | doaj-art-4049c8ddb51e4acaa0ec845dcc954a1a |
| institution | OA Journals |
| issn | 1674-0491 |
| language | zho |
| publishDate | 2022-12-01 |
| publisher | Editorial Office of Journal of Colorectal & Anal Surgery |
| record_format | Article |
| series | 结直肠肛门外科 |
| spelling | doaj-art-4049c8ddb51e4acaa0ec845dcc954a1a2025-08-20T01:51:45ZzhoEditorial Office of Journal of Colorectal & Anal Surgery结直肠肛门外科1674-04912022-12-0128655155710.19668/j.cnki.issn1674-0491.2022.06.006Mid-term oncological outcomes of transanal total mesorectal excision for rectal cancer: a prospective, single center, randomized controlled trialZhu Yongfei0Yang Xuanhua1Teng Qing2Guo Qing3Fu Zhiyong4Fan Yushi5Huang Haixia6Jing Rong7Zhou Dongbing8Qin Long9Li Quanlin10Tian Yunhong11Kang Liang12Ren Mingyang13Department of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, ChinaDepartment of Colorectal Surgery, the Sixth Affiliated Hospital of the Sun Yatsen University, Guangzhou 510655, Guangdong, ChinaDepartment of Gastrointestinal Surgery, Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China[Objectives] To compare mid-term oncological outcomes between transanal total mesorectal excision (taTME) and laparoscopic total mesorectal excision (lapTME) for rectal cancer. [Methods] This was a prospective randomized controlled trial of 68 patients with mid-and low rectal cancer admitted to the Nanchong Central Hospital—Affiliated Hospital of North Sichuan Medical College for planned radical surgery between December 2018 and April 2021. Patients were randomly assigned to the taTME group (n=33) and the lapTME group (n=35) using a random number table. One patient in the lapTME group was found during exploration to have peritoneal metastasis and excluded. The final study included 33 patients in the taTME group and 34 patients in the lapTME group. Pathology and follow-up data were collected and analyzed. Primary endpoints included two-year overall survival (OS), two-year disease-free survival (DFS), local recurrence, distant metastasis, and death. Secondary endpoint was pathology findings. [Results] No patients in either group showed positive distal resection margin or positive circumferential resection margin. The two groups did not differ significantly in terms of length of specimen, tumor length, distance between proximal and distal resection margin, distance between circumferential resection margin, grade of mesangial integrity, lymph node yield, T stage, N stage, and TNM stage (P>0.05). No patients were lost to follow-up. The Median follow-up was 31 (12, 40) months. Up to April 2022, no patients had local recurrence. One patient in the taTME group (3.0%) and one in the lapTME group (2.9%) was found to have lung metastasis at 18 and 19 months after surgery, respectively. No liver or other distant metastasis was reported. One patient in the taTME group died due to multiorgan failure caused by postoperative lung infection; one patient in the lapTME group had sudden death due to cardiac arrest at 1 month after surgery; no further death was reported during the follow-up period. The overall mortality rate was 3.0% in the taTME group and 2.9% in the lapTME group (P=1.000). Two-year OS was 97.0% in the taTME group and 97.1% in the lapTME group (P=0.986). Two-year DFS was 93.9% in the taTME group and 94.1% in the lapTME group (P=0.974). [Conclusion] TaTME is a safe and feasible treatment option for mid-and low rectal cancer. It can achieve comparable effectiveness and satisfactory mid-term oncological outcomes as lapTME.https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=322&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC6%E6%9C%9Frectal cancertransanal total mesorectal excisionlaparoscopic total mesorectal excisionmid-term oncological outcomes |
| spellingShingle | Zhu Yongfei Yang Xuanhua Teng Qing Guo Qing Fu Zhiyong Fan Yushi Huang Haixia Jing Rong Zhou Dongbing Qin Long Li Quanlin Tian Yunhong Kang Liang Ren Mingyang Mid-term oncological outcomes of transanal total mesorectal excision for rectal cancer: a prospective, single center, randomized controlled trial 结直肠肛门外科 rectal cancer transanal total mesorectal excision laparoscopic total mesorectal excision mid-term oncological outcomes |
| title | Mid-term oncological outcomes of transanal total mesorectal excision for rectal cancer: a prospective, single center, randomized controlled trial |
| title_full | Mid-term oncological outcomes of transanal total mesorectal excision for rectal cancer: a prospective, single center, randomized controlled trial |
| title_fullStr | Mid-term oncological outcomes of transanal total mesorectal excision for rectal cancer: a prospective, single center, randomized controlled trial |
| title_full_unstemmed | Mid-term oncological outcomes of transanal total mesorectal excision for rectal cancer: a prospective, single center, randomized controlled trial |
| title_short | Mid-term oncological outcomes of transanal total mesorectal excision for rectal cancer: a prospective, single center, randomized controlled trial |
| title_sort | mid term oncological outcomes of transanal total mesorectal excision for rectal cancer a prospective single center randomized controlled trial |
| topic | rectal cancer transanal total mesorectal excision laparoscopic total mesorectal excision mid-term oncological outcomes |
| url | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=322&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC6%E6%9C%9F |
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