The purpose of this study was to compare the long-term oncology outcomes and specimen quality of taTME and laTME in the treatment of middle and low rectal cancer by a large sample cohort. At the same time, the local recurrence following a primary rectal cancer resection was analyzed to respond to the concerns about the event of the national suspension for TaTME due to the high local recurrence rate in Norway.
Laparoscopic surgery is considered to have better visualization for more accurate separation and further injury reduction than open surgery. However, the oncology outcomes are still controversial. Especially in the challenging patients who have narrow and deep pelvic, the disadvantage that it is difficult to obtain high-quality resected specimens during laparoscopic TME (laTME) surgery is considered to be magnified. It is considered transanal total mesorectal excision (taTME) is an alternative method to solve this "old problem". However, as a new technology that has been around for only 10 years, the applicability of taTME worldwide needs to be further proved in long-term oncology. This prospective cohort study aimed to compare taTME surgery to laTME surgery for mid and low-rectal cancer on long-term oncology outcomes from a single, experienced Chinese center that was an early adopter of taTME.
Study Type
OBSERVATIONAL
Enrollment
2,502
transanal TME
Overall survival rate
Time frame: 5 years after the surgery
disease-free survival ratev
Time frame: 5 years after the surgery
Local recurrence rate
Local recurrence was defined as radiologic or histopathologic evidence of any recurrent disease deposit located in the pelvis in the prior area of dissection following a primary rectal cancer resection, with or without distal metastasis
Time frame: 3 years after the surgery
Cancer special survival rate
Cancer special survival was defined as the time from the date of primary rectal cancer resection to the date of death caused by rectal cancer.
Time frame: 5 years after the surgery
Quality of the mesorectum specimen
The quality of the resected mesorectum was classified into three grades: (a) incomplete, (b) nearly complete, and (c) complete
Time frame: 30 days after the surgery
CRM status
The CRM was regarded as positive if the tumor distance or malignant lymph node to CRM was ≦1 mm.
Time frame: 30 days after the surgery
DRM status
The DRM was regarded as positive if it was microscopically involved by or ≦1 mm from the tumor margins.
Time frame: 30 days after the surgery
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