Abdominal or Transanal TME in Therapy of Rectal Cancer: A Retrospective Cohort Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Survival
- Sponsor
- Cantonal Hospital of St. Gallen
- Enrollment
- 300
- Locations
- 1
- Primary Endpoint
- disease-specific survival
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
This study assessed whether transanal TME in patients with rectal cancer is superior to open, laparoscopic, and robotic TME (abdominal TME (abTME)) regarding oncological outcome, postoperative morbidity and 90-day mortality.
Detailed Description
Rectal cancer accounts for 3.8% of all new cancer diagnosis and for 3.4% of all cancer-related deaths in the world in 2020. Regarding treatment of rectal cancer, it is essential to perform surgery along the anatomical and embryological planes. This technique called total mesorectal excision (TME) reduces the local recurrence rate and improves the survival. Since the early 2000, TME has changed from open to laparoscopic approach due to better results in short-term outcome. Nevertheless, oncological benefits are modest. In 2009 the first ever transanal TME (taTME) war performed. This novel technique combines abdominal with transanal dissection. Because the distal part of the rectum is approached from below, a better visualization of the mesorectal plane resulting in higher rate of free CRM and of complete TME specimen grade (Quirke Score) can be accomplished. However, taTME remains a hot topic in the current scientific literature. In Norway and the Netherlands a higher rate of anastomotic leakage as well as a higher rate of local recurrence (9.5%) with multifocal growth pattern were described.
Investigators
Lukas Marti
Dr. med. Lukas Marti, Leitender Arzt Chirurgie
Cantonal Hospital of St. Gallen
Eligibility Criteria
Inclusion Criteria
- •all patients receiving elective total mesorectal excision
Exclusion Criteria
- •diagnosis other than rectal cancer
- •partial mesorectal excision
- •discontinuity resection (no anastomosis)
- •incomplete Staging
- •metastatic cancer
- •lack of follow-up
- •decline of a retrospective data Analysis
- •age under 18 years
Outcomes
Primary Outcomes
disease-specific survival
Time Frame: 60 months
time from surgery to end of follow-up or death due to or recurrence of rectal cancer
Overall survival
Time Frame: 60 months
time from surgery to end of follow-up or death
cancer-specific survival
Time Frame: 60 months
time from surgery to end of follow-up or death due to rectal cancer
Secondary Outcomes
- positive resection margin(30 days)
- relapse-free survival(60 months)
- number of lymph nodes(30 days)
- postoperative 90-day mortality(90 days)
- recurrence-free survival(60 months)
- postoperative morbidity(30 days)
- Quirke Score(30 days)
- circular resection margin (CRM)(30 days)