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 journalArticleAcademicpeer-review

4 Citations (Web of Science)

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 languageEnglish
Pages (from-to)991-997
Number of pages7
JournalBritish Journal of Surgery
Volume108
Issue number8
DOIs
Publication statusPublished - Aug 2021

Keywords

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

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