Quality of life and functional outcomes after laparoscopic total mesorectal excision (LaTME) and transanal total mesorectal excision (taTME) for rectal cancer. an updated meta-analysis.

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY International Journal of Colorectal Disease Pub Date : 2024-08-09 DOI:10.1007/s00384-024-04703-x
Sara Lauricella, Francesco Brucchi, Francesco Maria Carrano, Diletta Cassini, Roberto Cirocchi, Patricia Sylla
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Abstract

Purpose: Concerns exist regarding the potential for transanal total mesorectal excision (TaTME) to yield poorer functional outcomes compared to laparoscopic TME (LaTME). The aim of this study is to assess the functional outcomes following taTME and LaTME, focusing on bowel, anorectal, and urogenital disorders and their impact on the patient's QoL.

Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and A Measurement Tool to Assess systematic Reviews (AMSTAR) guidelines. A comprehensive search was conducted in Medline, Embase, Scopus, and Cochrane Library databases. The variables considered are: Low Anterior Resection Syndrome (LARS), International Prostate Symptom Score (IPSS) and Jorge-Wexner scales; European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C29 and QLQ-C30 scales.

Results: Eleven studies involving 1020 patients (497-taTME group/ 523-LaTME group) were included. There was no significant difference between the treatments in terms of anorectal function: LARS (MD: 2.81, 95% CI: - 2.45-8.08, p = 0.3; I2 = 97%); Jorge-Wexner scale (MD: -1.3, 95% CI: -3.22-0.62, p = 0.19). EORTC QLQ C30/29 scores were similar between the groups. No significant differences were reported in terms of urogenital function: IPSS (MD: 0.0, 95% CI: - 1.49-1.49, p = 0.99; I2 = 72%).

Conclusions: This review supports previous findings indicating that functional outcomes and QoL are similar for rectal cancer patients who underwent taTME or LaTME. Further research is needed to confirm these findings and understand the long-term impact of the functional sequelae of these surgical approaches.

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腹腔镜全直肠系膜切除术(LaTME)和经肛门全直肠系膜切除术(taTME)治疗直肠癌后的生活质量和功能预后:最新荟萃分析。
目的:经肛门全直肠系膜切除术(TaTME)与腹腔镜全直肠系膜切除术(LaTME)相比,可能会产生较差的功能性结果,这一点令人担忧。本研究旨在评估经肛门全直肠系膜切除术(TaTME)和腹腔镜全直肠系膜切除术(LaTME)后的功能效果,重点关注肠道、肛门直肠和泌尿生殖系统疾病及其对患者生活质量的影响:根据《系统综述和荟萃分析首选报告项目》(PRISMA)指南和《评估系统综述的测量工具》(AMSTAR)指南进行了系统综述。在 Medline、Embase、Scopus 和 Cochrane 图书馆数据库中进行了全面检索。考虑的变量包括低位前列腺切除综合征(LARS)、国际前列腺症状评分(IPSS)和 Jorge-Wexner 量表;欧洲癌症研究和治疗组织(EORTC)QLQ-C29 和 QLQ-C30 量表:共纳入11项研究,涉及1020名患者(497-taTME组/523-LaTME组)。两种治疗方法在肛门直肠功能方面无明显差异:LARS(MD:2.81,95% CI:- 2.45-8.08,p = 0.3;I2 = 97%);Jorge-Wexner量表(MD:-1.3,95% CI:-3.22-0.62,p = 0.19)。两组患者的 EORTC QLQ C30/29 评分相似。泌尿生殖功能方面无明显差异:IPSS(MD:0.0,95% CI:- 1.49-1.49,p = 0.99;I2 = 72%):本综述支持之前的研究结果,即接受 taTME 或 LaTME 治疗的直肠癌患者的功能预后和 QoL 相似。需要进一步的研究来证实这些发现,并了解这些手术方法对功能后遗症的长期影响。
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来源期刊
CiteScore
4.90
自引率
3.60%
发文量
206
审稿时长
3-8 weeks
期刊介绍: The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.
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