In a nutshell
This study evaluated the effectiveness and safety of transanal (ta) versus laparoscopic (lap) total mesorectal resection (TME) for the treatment of patients with stage I-III rectal cancer (RC). The data showed that experienced surgeons can safely perform taTME in these patients.
Rectal cancer (RC) is one of the most common types of cancer worldwide. RC involves the final part of the large intestine or rectum. The standard treatment for RC is usually surgery. Complete removal of the tumor is called total mesorectal excision (TME). There are different types of surgery to remove the rectal tumor.
Laparoscopic TME consists of the insertion of a thin tube with a camera through small cuts in the abdomen. This tube, which is guided by the doctor, is used to remove the tumor. Lap surgery is usually less invasive and is associated with fewer complications and faster healing after surgery. LapTME is currently the preferred method for the removal or RC.
Transanal TME is a less invasive procedure for the removal of early rectal tumors. A tube with a camera is inserted through the rectum and tumors are removed without the need for a surgical opening. This technique offers greater organ preservation and decreases the risk of following surgery. However, the effectiveness and safety of taTME versus lapTME for the treatment of patients with RC are still unknown.
Methods & findings
This study involved 1089 patients with stage I-III RC. Patients were randomly assigned into two groups. Group 1 included 544 patients who received taTME. Group 2 included 545 patients who received lapTME.
4.8% of the patients in group 1 experienced complications during surgery versus 6.1% of the patients in group 2. This difference was not statistically significant.
13.4% of the patients in group 1 experienced complications after surgery versus 12.1% of the patients in group 2. This difference was not statistically significant.
Successful resection occurred in 98.9% of the patients in group 1 versus 98.7% of the patients in group 2. This difference was not statistically significant.
The bottom line
This study concluded that experienced surgeons can safely perform transanal TME in patients with stage I-III RC.
The fine print
This study only included patients treated at institutions in China. All the surgeons participating in the study had technical expertise in transanal TME. More studies in different countries are needed before transanal TME is generally accepted.
Published By :
Annals of Surgery
Jul 11, 2022
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