Annals of Coloproctology

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Original Article

Malignant disease, Rectal cancer,Colorectal cancer,Functional outcome,Surgical technique

Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands: Joost A.G. van der Heijden, Kelly G.H. van de Pas, Frank J.C. van den Broek, Francois M.H. van Dielen, Gerrit D. Slooter, Adriana J.G. Maaskant-Braat; Ann Coloproctol. 2022;38(1):28-35. Published online June 29, 2021; DOI: https://doi.org/10.3393/ac.2020.00773.0110

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11 Citations

Purpose
Transanal total mesorectal excision (TaTME) was developed to overcome surgical difficulties experienced in distal pelvic dissection. Concerns have been raised about potential worse postoperative functional outcomes after TaTME. Also, the oncological safety was questioned. This study aimed to describe the functional, surgical, oncological outcomes and quality of life (QoL) after TaTME.
Methods
All consecutive TaTME cases for rectal cancer without disseminated disease between December 2016 and April 2019 were included. The Wexner incontinence score, low anterior resection syndrome (LARS) score, fecal incontinence-related QoL, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-core questionnaire and 29-item module (EORTC QLQ-C30/CR29) were collected. Kaplan-Meier analysis was used to calculate local recurrence-free survival.
Results
Thirty patients were eligible for analysis of which 23 received questionnaires. Response rate was 74%. After a median follow-up of respectively 20.0 and 23.0 months for functional and oncological outcomes, the median (interquartile range) of Wexner incontinence and LARS scores were 9.0 (7.0–12.0) and 33.1 (25.0–39.0). Major LARS was present in 73.3%. Fecal incontinence, general and colorectal-specific QoL subdomains that are associated with poor bowel function scored in line with previously reported data. The 2-year actuarial cumulative local recurrence rate was 3.7% (95% confidence interval, 2.4%–5.0%).
Conclusion
TaTME may lead to significant functional impairments. Patients should receive preoperative counseling on this topic and be fully aware of the potential consequences of their treatment. Oncological data were in line with other short- to moderate-term data and did not show alarming results.

Citations

Citations to this article as recorded by

Does transanal total mesorectal excision (taTME) result in better quality of life and functional outcomes than traditional TME does? A retrospective propensity score-adjusted cohort study
Yanic Ammann, Marie Klein, Lukas Marti, Rene Warschkow, Lennard Ströse, Moritz Sparn, Tarkan Jäger, Stephan Bischofberger, Walter Brunner
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef
Anorectal and urogenital functional outcome after robotic and transanal total mesorectal excision for rectal cancer: a propensity score-matched analysis
Pak Chiu Wong, Felix Che Lok Chow, Wai Lun Law, Chi Chung Foo
Techniques in Coloproctology.2025;[Epub] CrossRef
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Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
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The Ewha Medical Journal.2023;[Epub] CrossRef
Quality of life and functional outcomes after transanal total mesorectal excision for rectal cancer—results from the implementation period in Denmark
M. X. Bjoern, F. B. Clausen, M. Seiersen, O. Bulut, F. Bech-Knudsen, J. E. Jansen, I. Gögenur, M. F. Klein
International Journal of Colorectal Disease.2022; 37(9): 1997. CrossRef
Analgesic effect of structured anal skin care for perianal dermatitis after low anterior resection in the rectal cancer patients: prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial
Gyung Mo Son, In Young Lee, Mi Sook Yun, Jung-Hea Youn, Hong Min An, Kyung Hee Kim, Seung Mi Yeo, Bokyung Ku, Myeong Suk Kwon, Kun Hyung Kim
Annals of Surgical Treatment and Research.2022; 103(6): 360. CrossRef
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Annals of Coloproctology.2021; 37(6): 395. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef

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