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Short- and long-term outcomes of transanal versus laparoscopic total mesorectal excision for mid-to-low rectal cancer: a meta-analysis

机译：TransAnalal与腹腔镜的短期和长期结果，用于中低直肠癌的腹腔镜总切除术：Meta分析

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摘要

Background and objectivesTransanal total mesorectal excision (TaTME) is positioned at the cutting edge of minimally invasive approach to mid- and low rectal cancer. This meta-analysis was to compare the short- and long-term outcomes of TaTME versus laparoscopic total mesorectal excision (LTME) and to evaluate the safety, efficacy, and possible superiority of TaTME.MethodsA comprehensive search was conducted for randomized controlled trials (RCTs) and non-RCTs (NRCTs) comparing TaTME with LTME. Inter-group differences were evaluated via standardized mean differences and relative risks (RRs). All outcomes were analyzed using fixed effects or random effects models according to the heterogeneity. Statistical analysis was performed using Stata/SE 12.0 software.ResultsEleven studies (1 RCT and 10 NRCTs) with involving 757 patients were included. Among which, 361 patients underwent TaTME and 396 patients underwent LTME. Comparing the surgical and oncological quality of resection of TaTME with that of LTME, reports of TaTME indicated favorable outcomes considering mesorectal resection quality, circumferential resection margin involvement, intraoperative blood loss, conversions, and postoperative complications, while the differences between the two groups had no statistical significance in terms of distal resection margin, harvested lymph node, operation time, hospital stay, recurrence, 2-year overall survival (OS), and 2-year disease-free survival.ConclusionTaTME is a promising surgical technique and is fully a safe, efficacious, and diffusible alternative to LTME in managing mid- and distal rectal cancer. Larger scale, national, multicentric RCTs are warranted to further verify these results and the possible superiority of TaTME.
机译：背景和客观的雌颅颅全培素切除（TATME）定位在最微外侵入性的中低直肠癌的切削刃处。这种荟萃分析是比较TATME与腹腔镜总培养基切除（LTME）的短期和长期结果，并评估TATME.METMEMEMEMEMEM的安全性，疗效和可能的优越性是针对随机对照试验进行的（RCTS使用LTME比较TATME的非RCT（NRCTS）。通过标准化平均差异和相对风险（RRS）评估组间差异。使用根据异质性的固定效果或随机效果模型分析所有结果。使用STATA / SE 12.0软件进行统计分析。包括涉及757名患者的研究（1 rct和10个NRCT）。其中，361名患者接受了TATME和396名患者进行LTME。比较TATME的切除手术和肿瘤术质量，TATME的报道表明，考虑了考虑培素切除质量，周向切除边缘参与，术中失血，转化率和术后并发症的良好结果，而两组之间的差异则没有远端切除缘，收获的淋巴结，操作时间，住院，复发，2年整体存活（OS）和2年无病保存的统计学意义.Conclusiontatme是一个有前途的手术技术，完全安全在管理中远端癌症中的LTME有效，有效，可扩散替代品。较大规模，国家，多中心RCT被认为是进一步验证这些结果以及TATME可能的优势。

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  • 来源
    《Surgical Endoscopy》 |2019年第3期|共14页
  • 作者

    Zhang Xuan; Gao Yi; Dai XingLong; Zhang HongTao; Shang ZhongJun; Cai XinYi; Shen Tao; Cheng XianShuo; Yu Kun; Li YunFeng;

  • 作者单位

    Kunming Med Univ Dept Colorectal Canc Surg Clin Res Ctr Colorectal Canc Tumor Hosp Yun Nan Prov;

    Kunming Med Univ Dept Colorectal Canc Surg Clin Res Ctr Colorectal Canc Tumor Hosp Yun Nan Prov;

    Chongqing Med Univ Affiliated Hosp 1 Dept Gastrointestinal Surg Chongqing Peoples R China;

    Kunming Med Univ Dept Colorectal Canc Surg Clin Res Ctr Colorectal Canc Tumor Hosp Yun Nan Prov;

    Kunming Med Univ Affiliated Hosp 3 Tumor Hosp Yun Nan Prov Dept Hosp Affairs Management Kunming;

    Kunming Med Univ Dept Colorectal Canc Surg Clin Res Ctr Colorectal Canc Tumor Hosp Yun Nan Prov;

    Kunming Med Univ Dept Colorectal Canc Surg Clin Res Ctr Colorectal Canc Tumor Hosp Yun Nan Prov;

    Kunming Med Univ Dept Colorectal Canc Surg Clin Res Ctr Colorectal Canc Tumor Hosp Yun Nan Prov;

    Kunming Med Univ Dept Colorectal Canc Surg Clin Res Ctr Colorectal Canc Tumor Hosp Yun Nan Prov;

    Kunming Med Univ Dept Colorectal Canc Surg Clin Res Ctr Colorectal Canc Tumor Hosp Yun Nan Prov;

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  • 正文语种 eng
  • 中图分类 诊断学;
  • 关键词

    Rectal cancer; Transanal; Laparoscopy; Total mesorectal excision; Meta-analysis;

    机译：直肠癌;Transanal;腹腔镜;总部分切除术;Meta分析;

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