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Three-year outcomes of transanal total mesorectal excision versus standard laparoscopic total mesorectal excision for mid and low rectal cancer

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Abstract

Introduction

Since transanal total mesorectal excision (taTME) was introduced, it has become an important topic in rectal cancer treatment. Many previous studies reported positive relevant short-term results, histopathological results, and associated complications. Recently, concerns regarding the oncological safety of taTME have been raised due to reports showing high local recurrences (LR) rates. Therefore, this study aimed to compare the 3-year outcomes between taTME and laparoscopic total mesorectal excision (laTME) for mid-low rectal cancer.

Methods

A total of 104 patients who underwent taTME were matched with 208 patients treated by laTME. The primary endpoint was 3-year LR rate; secondary endpoints in this matched-cohort study included the perioperative outcomes and histopathological outcomes.

Results

taTME was associated with lower permanent ostomy rate (1% vs 13.5%) and lower conversion rate (0% vs 3.4%) compared to laTME. A similar quality of resected specimens was detected for each group. In both groups, the local recurrence rate was 3.8%. Within 3 years after surgery, the disease-free survival (DFS) rates were 78.8% in the taTME group and 76.9% in the laTME group (P = 0.640), while the overall survival (OS) rates were 93.3% in the taTME group and 89.9% in the laTME group (P = 0.327).

Conclusion

No significant differences regarding 3-year local recurrence rate (3.8%) were observed in the taTME group compared to laTME group.

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Acknowledgements

We would like to thank Dr. Dyke, Dr. Kenneth, and Dr. Weiwei Shi for the scientific editing, and Zijun Huang and Yanping Liu for collecting some of the data.

Funding

This project was supported by grants from the Fundamental Research Funds for the Central Universities (Grant No. 16ykjc25 to Liang Kang) and Sun Yat-sen University Clinical Research 5010 Program (Grant No. 2016005 to Liang Kang).

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Author notes

  1. Ziwei Zeng and Zhihang Liu contributed equally to this study.

Authors and Affiliations

  1. Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, Guangdong, People’s Republic of China

    Ziwei Zeng, Zhihang Liu, Shuangling Luo, Zhenxing Liang, Liang Huang, Lei Ruan, Junji Chen, Haiqing Jie, Wenfeng Liang, Huashan Liu & Liang Kang

  2. Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, Guangdong, People’s Republic of China

    Ziwei Zeng, Zhihang Liu, Shuangling Luo, Zhenxing Liang, Liang Huang, Junji Chen, Haiqing Jie, Wenfeng Liang, Huashan Liu & Liang Kang

  3. Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, Guangdong, People’s Republic of China

    Ziwei Zeng, Zhihang Liu, Shuangling Luo, Zhenxing Liang, Liang Huang, Junji Chen, Haiqing Jie, Wenfeng Liang, Huashan Liu & Liang Kang

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  1. Ziwei Zeng
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Correspondence to Huashan Liu or Liang Kang.

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Drs. Zeng, Liu, Liu, Luo, Liang, Huang, Ruan, Chen, Jie, Liang, and Kang have no conflicts of interest or financial ties to disclose. All authors are aware of and agree to the content of the paper and their being listed as an author of the paper.

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Zeng, Z., Liu, Z., Luo, S. et al. Three-year outcomes of transanal total mesorectal excision versus standard laparoscopic total mesorectal excision for mid and low rectal cancer. Surg Endosc 36, 3902–3910 (2022). https://doi.org/10.1007/s00464-021-08707-4

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