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. 2019 Jan;33(1):79-87.
doi: 10.1007/s00464-018-6276-z. Epub 2018 Jul 2.

Quality of life after rectal cancer surgery: differences between laparoscopic and transanal total mesorectal excision

Marloes Veltcamp Helbach  1   2 , Thomas W A Koedam  3 , Joep J Knol  4 , Simone Velthuis  5 , H Jaap Bonjer  3 , Jurriaan B Tuynman  3 , Colin Sietses  5
Affiliations

Quality of life after rectal cancer surgery: differences between laparoscopic and transanal total mesorectal excision

Marloes Veltcamp Helbach et al. Surg Endosc. 2019 Jan.

Abstract

Background: Transanal total mesorectal excision (TaTME) is a safe alternative to laparoscopic TME for mid and low rectal cancer. TaTME allows improved visualization of the surgical planes and margins, and may potentially improve oncological outcomes. However, functional results after total mesorectal excision (TME) are variable and there are currently only a few published studies that include functional data related to the outcomes of TaTME.

Methods: Fifty-four consecutive patients were included in this study: one group included 27 patients who underwent laparoscopic low anterior and the other included 27 patients who underwent TaTME. All patients were asked to complete five questionnaires related to quality of life (QOL) and function [EQ-5D-3L, EORTC-QLQ C30, EORTC-QLQ C29, Low Anterior Resection Syndrome score (LARS), and International Prostate Symptom Score IPSS]. All TaTME patients were operated on at The Gelderse Vallei Hospital by a single surgeon and had a follow-up of at least 6.6 months.

Results: The EORTC-QLQ C30 and EQ-5D-3L questionnaires showed comparable outcomes in terms of QOL between the two groups. Almost all items evaluated by the EORTC-QLQ C29, including sexual outcomes, were similar between the two groups. One item concerning fecal incontinence, however, was scored worse for TaTME. There were no significant differences between the groups in terms of LARS symptoms or urinary function.

Conclusions: Patients undergoing laparoscopic or transanal TME showed comparable functional and QOL outcomes. Although the TaTME technique is still evolving, this study indicates that this technique is a safe alternative to laparoscopic surgery in terms of functional outcomes for mid and low rectal cancers.

Keywords: Quality of life; Rectal cancer; Surgery; TAMIS; Transanal TME.

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Conflict of interest statement

Drs. J. Knol reports personal fees from Medtronic, Johnson & Johnson, and Applied Medical outside the submitted work. Dr. J. Bonjer reports grants from Stryker and Applied Medical, grants and personal fees from Olympus and Ethicon Endosurgery outside the submitted work. Dr. J. Tuynman reports grants from Dutch Cancer Society and personal fees from Applied Medical outside the submitted work. Dr. C. Sietses reports grants from Olympus and Applied medical and personal fees from Medtronic and Applied Medical outside the submitted work. Drs. M. Veltcamp Helbach, Drs. T. Koedam, and Dr. S. Velthuis have no conflict of interest or financial ties to disclose.

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