Transanal total mesorectal excision and low anterior resection syndrome
Author:
van der Heijden J A G1ORCID, Qaderi S M1, Verhoeven R23, Custers J A E4, Klarenbeek B R1, Maaskant-Braat A J G5, de Wilt J H W1ORCID, Beets G L, Belt E J Th, Berbée M, Beverdam F H, Blankenburgh R, Coene P P L O, de Groot J W B, de Hingh I H J T, de Vos A I, de Wilt J H W, Dekker J W T, Erdkamp F L G, Haringhuizen A W, Helgason H H, Hendriks M P, Hoekstra R, Ijzermans J N M, Jansen J, Kloppenberg F W H, Los M, Meijerink M R, Mekenkamp L J M, Nieboer P, Peeters K C M J, Peters N A J B, Polée M B, Verdaasdonk E G G, Quarles van Ufford-Mannesse P, Rietbroek R C, Schiphorst A H W, Schouten van der Velden A, Schrauwen R W M, Sie M P S, Simkens L, Sommeijer D W, Sonneveld D J A, Spierings L E A, Stockmann H B A C, Talsma K, ten Tije A J, Terheggen F, Tjin-A-Ton M L R, Valkenburg-van Iersel L B J, van Cruijsen H, van der Velden A M T, van Dodewaard-de Jong J M, van Lent A U G, van Voorthuizen T, Vermaas M, Vles W J, Vogelaar J F J, Zimmerman D D E, van Grevenstein H W M U, Vink G R,
Affiliation:
1. Department of Surgical Oncology, Radboud Institute for Health Science (RIHS), Radboud University Medical Centre, Nijmegen, the Netherlands 2. Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands 3. Amsterdam UMC, Department of Medical Oncology, Cancer Centre Amsterdam, Amsterdam, the Netherlands 4. Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, the Netherlands 5. Department of Surgical Oncology, Máxima Medical Centre, Veldhoven, the Netherlands
Abstract
Abstract
Background
Bowel dysfunction after rectal cancer surgery is common, with some experiencing low anterior resection syndrome (LARS) is common after rectal cancer surgery. This study examined if transanal total mesorectal excision (TaTME) has a similar risk of LARS and altered quality of life (QoL) as patients who undergo low anterior resection (LAR).
Methods
Patients who underwent TaTME or traditionally approached total mesorectal excision in a prospective colorectal cancer cohort study (2014–2019) were propensity score matched in a 1 : 1 ratio. LARS and QoL scores were assessed before and after surgery with a primary endpoint of major LARS at 12 months analysed for possible association between factors by logistic regression.
Results
Of 61 TaTME and 317 LAR patients eligible, 55 from each group were propensity score matched. Higher LARS scores (30.6 versus 25.4, P = 0.010) and more major LARS (65 versus 42 per cent, P = 0.013; OR 2.64, 95 per cent c.i. 1.22 to 5.71) were reported after TaTME. Additionally, QoL score differences (body image, bowel frequency, and embarrassment) were worse in the TaTME group.
Conclusions
TaTME may be associated with more severe bowel dysfunction than traditional approaches to rectal cancer.
Funder
Prospective Dutch Colorectal Cancer Cohort
Publisher
Oxford University Press (OUP)
Cited by
15 articles.
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