Transanal total mesorectal excision for locally advanced rectal cancer following neoadjuvant chemoradiotherapy.

IF 1.6 4区医学 Q2 SURGERY Surgery Today Pub Date : 2025-10-01 Epub Date: 2025-04-08 DOI:10.1007/s00595-025-03042-w

Takeru Matsuda, Kimihiro Yamashita, Hiroshi Hasegawa, Ryuichiro Sawada, Yasufumi Koterazawa, Hitoshi Harada, Naoki Urakawa, Hironobu Goto, Shingo Kanaji, Yoshihiro Kakeji

{"title":"Transanal total mesorectal excision for locally advanced rectal cancer following neoadjuvant chemoradiotherapy.","authors":"Takeru Matsuda, Kimihiro Yamashita, Hiroshi Hasegawa, Ryuichiro Sawada, Yasufumi Koterazawa, Hitoshi Harada, Naoki Urakawa, Hironobu Goto, Shingo Kanaji, Yoshihiro Kakeji","doi":"10.1007/s00595-025-03042-w","DOIUrl":null,"url":null,"abstract":"Purpose: To examine the clinical impact of transanal total mesorectal excision (TaTME) for locally advanced rectal cancer after neoadjuvant chemoradiotherapy (NACRT).Methods: This retrospective study included 91 patients undergoing surgery for rectal cancer after NACRT between 2011 and 2022. Among them, 24, 22, and 45 patients underwent open (Open), conventional laparoscopic (Lap), and TaTME surgeries, respectively. We compared their clinical outcomes.Results: Operative time, blood loss, transfusion, morbidity, and hospital stay were significantly lower in the TaTME group than in the Open or Lap groups. The multivariate regression analyses identified only the TaTME approach as a significant factor for reducing morbidity. Both 3 yrear relapse-free survival (RFS) and local recurrence-free survival (LRFS) were significantly better in the TaTME group than in the Open or Lap groups (3 yr RFS: 94.7%, 80.4%, and 66.7%, and 3 yr LRFS: 100%, 90.5%, and 82.2% for the TaTME, Lap, and Open groups, respectively). Multivariate analyses of potential risk factors for recurrence identified body mass index, combined resection, and pathological stage, but not the TaTME approach, as significant predictors of recurrence.Conclusion: TaTME reduced morbidity significantly in patients with locally advanced rectal cancer undergoing NACRT, compared with open or laparoscopic surgery.","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1373-1382"},"PeriodicalIF":1.6000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery Today","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00595-025-03042-w","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/8 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To examine the clinical impact of transanal total mesorectal excision (TaTME) for locally advanced rectal cancer after neoadjuvant chemoradiotherapy (NACRT).

Methods: This retrospective study included 91 patients undergoing surgery for rectal cancer after NACRT between 2011 and 2022. Among them, 24, 22, and 45 patients underwent open (Open), conventional laparoscopic (Lap), and TaTME surgeries, respectively. We compared their clinical outcomes.

Results: Operative time, blood loss, transfusion, morbidity, and hospital stay were significantly lower in the TaTME group than in the Open or Lap groups. The multivariate regression analyses identified only the TaTME approach as a significant factor for reducing morbidity. Both 3 yrear relapse-free survival (RFS) and local recurrence-free survival (LRFS) were significantly better in the TaTME group than in the Open or Lap groups (3 yr RFS: 94.7%, 80.4%, and 66.7%, and 3 yr LRFS: 100%, 90.5%, and 82.2% for the TaTME, Lap, and Open groups, respectively). Multivariate analyses of potential risk factors for recurrence identified body mass index, combined resection, and pathological stage, but not the TaTME approach, as significant predictors of recurrence.

Conclusion: TaTME reduced morbidity significantly in patients with locally advanced rectal cancer undergoing NACRT, compared with open or laparoscopic surgery.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

新辅助化放疗后经肛门全直肠系膜切除术治疗局部晚期直肠癌。

目的：探讨经肛门全肠系膜切除术（TaTME）治疗局部晚期直肠癌新辅助放化疗（NACRT）后的临床效果。方法：本回顾性研究纳入2011年至2022年期间91例直肠癌NACRT术后手术患者。其中，开放式（open）、常规腹腔镜（Lap）、TaTME手术分别为24例、22例、45例。我们比较了他们的临床结果。结果：TaTME组的手术时间、出血量、输血量、发病率和住院时间明显低于Open组和Lap组。多变量回归分析仅确定TaTME方法是降低发病率的重要因素。TaTME组的3年无复发生存率（RFS）和局部无复发生存率（LRFS）均显著优于Open组或Lap组（TaTME组、Lap组和Open组的3年RFS分别为94.7%、80.4%和66.7%，3年LRFS分别为100%、90.5%和82.2%）。复发的潜在危险因素的多因素分析确定了体重指数、联合切除和病理分期，而不是TaTME方法，作为复发的重要预测因素。结论：与开放或腹腔镜手术相比，TaTME可显著降低局部晚期直肠癌行NACRT患者的发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.