Transanal total mesorectal excision and low anterior resection syndrome

J. A. G. van der Heijden; S. M. Qaderi; R. Verhoeven; J. A. E. Custers; B. R. Klarenbeek; A. J. G. Maaskant-Braat; J. H. W. de Wilt; Ignace De Hingh; PLCRC Group

doi:10.1093/bjs/znab056

Transanal total mesorectal excision and low anterior resection syndrome

J. A. G. van der Heijden, S. M. Qaderi, R. Verhoeven, J. A. E. Custers, B. R. Klarenbeek, A. J. G. Maaskant-Braat, J. H. W. de Wilt^*, Ignace De Hingh, PLCRC Group

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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.

Original language	English
Pages (from-to)	991-997
Number of pages	7
Journal	British Journal of Surgery
Volume	108
Issue number	8
DOIs	https://doi.org/10.1093/bjs/znab056
Publication status	Published - Aug 2021

Keywords

QUALITY-OF-LIFE
RECTAL-CANCER
PREOPERATIVE RADIOTHERAPY
CLINICAL-TRIALS
MULTICENTER
SURGERY
PROCTECTOMY
INSTRUMENT
IMPACT
TATME

Access to Document

10.1093/bjs/znab056

Cite this

@article{2e1366a9a2bf407f8ef92c01e78a5699,

title = "Transanal total mesorectal excision and low anterior resection syndrome",

abstract = "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.",

keywords = "QUALITY-OF-LIFE, RECTAL-CANCER, PREOPERATIVE RADIOTHERAPY, CLINICAL-TRIALS, MULTICENTER, SURGERY, PROCTECTOMY, INSTRUMENT, IMPACT, TATME",

author = "{van der Heijden}, {J. A. G.} and Qaderi, {S. M.} and R. Verhoeven and Custers, {J. A. E.} and Klarenbeek, {B. R.} and Maaskant-Braat, {A. J. G.} and {de Wilt}, {J. H. W.} and {De Hingh}, Ignace and {PLCRC Group}",

note = "Publisher Copyright: {\textcopyright} 2021 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.",

year = "2021",

month = aug,

doi = "10.1093/bjs/znab056",

language = "English",

volume = "108",

pages = "991--997",

journal = "British Journal of Surgery",

issn = "0007-1323",

publisher = "Wiley",

number = "8",

}

TY - JOUR

T1 - Transanal total mesorectal excision and low anterior resection syndrome

AU - van der Heijden, J. A. G.

AU - Qaderi, S. M.

AU - Verhoeven, R.

AU - Custers, J. A. E.

AU - Klarenbeek, B. R.

AU - Maaskant-Braat, A. J. G.

AU - de Wilt, J. H. W.

AU - De Hingh, Ignace

AU - PLCRC Group

N1 - Publisher Copyright: © 2021 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.

PY - 2021/8

Y1 - 2021/8

N2 - 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.

AB - 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.

KW - QUALITY-OF-LIFE

KW - RECTAL-CANCER

KW - PREOPERATIVE RADIOTHERAPY

KW - CLINICAL-TRIALS

KW - MULTICENTER

KW - SURGERY

KW - PROCTECTOMY

KW - INSTRUMENT

KW - IMPACT

KW - TATME

U2 - 10.1093/bjs/znab056

DO - 10.1093/bjs/znab056

M3 - Article

C2 - 33837383

SN - 0007-1323

VL - 108

SP - 991

EP - 997

JO - British Journal of Surgery

JF - British Journal of Surgery

IS - 8

ER -