Transanal total mesorectal excision and low anterior resection syndrome.
Female
Humans
Incidence
Laparoscopy
/ adverse effects
Male
Middle Aged
Netherlands
/ epidemiology
Postoperative Complications
/ epidemiology
Proctectomy
/ adverse effects
Propensity Score
Prospective Studies
Rectal Neoplasms
/ surgery
Rectum
/ surgery
Syndrome
Transanal Endoscopic Surgery
/ adverse effects
Journal
The British journal of surgery
ISSN: 1365-2168
Titre abrégé: Br J Surg
Pays: England
ID NLM: 0372553
Informations de publication
Date de publication:
19 08 2021
19 08 2021
Historique:
received:
07
12
2020
revised:
22
01
2021
accepted:
27
01
2021
pubmed:
11
4
2021
medline:
17
12
2021
entrez:
10
4
2021
Statut:
ppublish
Résumé
Bowel dysfunction after rectal cancer surgery is common, with some experiencing low anterior resection syndrome (LARS) is common after rectal cancer surgery. This study examined if transanal total mesorectal excision (TaTME) has a similar risk of LARS and altered quality of life (QoL) as patients who undergo low anterior resection (LAR). Patients who underwent TaTME or traditionally approached total mesorectal excision in a prospective colorectal cancer cohort study (2014-2019) were propensity score matched in a 1 : 1 ratio. LARS and QoL scores were assessed before and after surgery with a primary endpoint of major LARS at 12 months analysed for possible association between factors by logistic regression. Of 61 TaTME and 317 LAR patients eligible, 55 from each group were propensity score matched. Higher LARS scores (30.6 versus 25.4, P = 0.010) and more major LARS (65 versus 42 per cent, P = 0.013; OR 2.64, 95 per cent c.i. 1.22 to 5.71) were reported after TaTME. Additionally, QoL score differences (body image, bowel frequency, and embarrassment) were worse in the TaTME group. TaTME may be associated with more severe bowel dysfunction than traditional approaches to rectal cancer.
Sections du résumé
BACKGROUND
Bowel dysfunction after rectal cancer surgery is common, with some experiencing low anterior resection syndrome (LARS) is common after rectal cancer surgery. This study examined if transanal total mesorectal excision (TaTME) has a similar risk of LARS and altered quality of life (QoL) as patients who undergo low anterior resection (LAR).
METHODS
Patients who underwent TaTME or traditionally approached total mesorectal excision in a prospective colorectal cancer cohort study (2014-2019) were propensity score matched in a 1 : 1 ratio. LARS and QoL scores were assessed before and after surgery with a primary endpoint of major LARS at 12 months analysed for possible association between factors by logistic regression.
RESULTS
Of 61 TaTME and 317 LAR patients eligible, 55 from each group were propensity score matched. Higher LARS scores (30.6 versus 25.4, P = 0.010) and more major LARS (65 versus 42 per cent, P = 0.013; OR 2.64, 95 per cent c.i. 1.22 to 5.71) were reported after TaTME. Additionally, QoL score differences (body image, bowel frequency, and embarrassment) were worse in the TaTME group.
CONCLUSIONS
TaTME may be associated with more severe bowel dysfunction than traditional approaches to rectal cancer.
Identifiants
pubmed: 33837383
pii: 6219385
doi: 10.1093/bjs/znab056
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
991-997Investigateurs
G L Beets
(GL)
E J Th Belt
(EJT)
M Berbée
(M)
F H Beverdam
(FH)
R Blankenburgh
(R)
P P L O Coene
(PPLO)
J W B de Groot
(JWB)
I H J T de Hingh
(IHJT)
A I de Vos
(AI)
J H W de Wilt
(JHW)
J W T Dekker
(JWT)
F L G Erdkamp
(FLG)
A W Haringhuizen
(AW)
H H Helgason
(HH)
M P Hendriks
(MP)
R Hoekstra
(R)
J N M Ijzermans
(JNM)
J Jansen
(J)
F W H Kloppenberg
(FWH)
M Los
(M)
M R Meijerink
(MR)
L J M Mekenkamp
(LJM)
P Nieboer
(P)
K C M J Peeters
(KCMJ)
N A J B Peters
(NAJB)
M B Polée
(MB)
E G G Verdaasdonk
(EGG)
P Quarles van Ufford-Mannesse
(P)
R C Rietbroek
(RC)
A H W Schiphorst
(AHW)
A Schouten van der Velden
(A)
R W M Schrauwen
(RWM)
M P S Sie
(MPS)
L Simkens
(L)
D W Sommeijer
(DW)
D J A Sonneveld
(DJA)
L E A Spierings
(LEA)
H B A C Stockmann
(HBAC)
K Talsma
(K)
A J Ten Tije
(AJ)
F Terheggen
(F)
M L R Tjin-A-Ton
(MLR)
L B J Valkenburg-van Iersel
(LBJ)
H van Cruijsen
(H)
A M T van der Velden
(AMT)
J M van Dodewaard-de Jong
(JM)
A U G van Lent
(AUG)
T van Voorthuizen
(T)
M Vermaas
(M)
W J Vles
(WJ)
J F J Vogelaar
(JFJ)
D D E Zimmerman
(DDE)
H W M U van Grevenstein
(HWMU)
G R Vink
(GR)
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com.