Research progress of functional outcomes secondary to transanal total mesorectal excision_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GUO Qing ,  REN Mingyang

Department of Gastrointestinal Surgery, Nanchong Central Hospital, The Second Clinical Medical College of North Sichuan Medical College, Nangchong, Sichuan 637000, P. R. China;

Corresponding author：

REN Mingyang, Email: 2861746489@qq.com

Keywords：

transanal total mesorectal excision; rectal cancer; anal function; organ function

DOI：

10.7507/1007-9424.201905056

Video：

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Objective To summarize the functional outcomes of transanal total mesorectal excision (TaTME).Method The literatures about functional outcomes and existing problems secondary to TaTME in China and abroad were collected to make a review.Results Neither the TaTME or the laparoscopic TME (LTME) had few serious impact on the quality of life of patients. At present, only a few studies were involved in the postoperative sexual function, and no definite conclusion could be drawn. From the current data only, the TaTME had few serious impact on the sexual function and it didn’t show some advantages as compared with the LTME. The urinary and defecation functions showed no obvious differences between the TaTME and the LTME, which of the patients after the TaTME might be impaired to some extent. The defecation disorders mainly occurred in 1—6 months after the TaTME, but it would recover to a certain extent as time went on.Conclusions Although TaTME has more advantages in protecting pelvic autonomic nerves, there is no obvious difference in postoperative organ function as compared with LTME surgery at present. Multi-center, large sample size, and long-term follow-up studies are still needed to validate long-term results.

Citation： GUO Qing, REN Mingyang. Research progress of functional outcomes secondary to transanal total mesorectal excision. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(1): 113-117. doi: 10.7507/1007-9424.201905056 Copy

1.	Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg, 1982, 69(10): 613-616.
2.	申占龙, 叶颖江, 王杉. 直肠癌全直肠系膜切除术中盆腔植物神经的易损区域及保护. 中华结直肠疾病电子杂志, 2018, 7(1): 8-11.
3.	Kneist W, Hanke L, Kauff DW, et al. Surgeons’ assessment of internal anal sphincter nerve supply during TaTME—inbetween expectations and reality. Minim Invasive Ther Allied Technol, 2016, 25(5): 241-246.
4.	Chouillard E, Regnier A, Vitte RL, et al. Transanal NOTES total mesorectal excision (TME) in patients with rectal cancer: Is anatomy better preserved? Tech Coloproctol, 2016, 20(8): 537-544.
5.	Lacy AM, Adelsdorfer C, Delgado S, et al. Minilaparoscopy-assisted transrectal low anterior resection (LAR): a preliminary study. Surg Endosc, 2013, 27(1): 339-346.
6.	Velthuis S, van den Boezem PB, van der Peet DL, et al. Feasibility study of transanal total mesorectal excision. Br J Surg, 2013, 100(6): 828-831.
7.	Lacy AM, Tasende MM, Delgado S, et al. Transanal total mesorectal excision for rectal cancer: outcomes after 140 patients. J Am Coll Surg, 2015, 221(2): 415-423.
8.	Veltcamp Helbach M, Deijen CL, Velthuis S, et al. Transanal total mesorectal excision for rectal carcinoma: short-term outcomes and experience after 80 cases. Surg Endosc, 2016, 30(2): 464-470.
9.	Simillis C, Hompes R, Penna M, et al. A systematic review of transanal total mesorectal excision: is this the future of rectal cancer surgery? Colorectal Dis, 2016, 18(1): 19-36.
10.	Deijen CL, Tsai A, Koedam TW, et al. Clinical outcomes and case volume effect of transanal total mesorectal excision for rectal cancer: a systematic review. Tech Coloproctol, 2016, 20(12): 811-824.
11.	Croese AD, Lonie JM, Trollope AF, et al. A meta-analysis of the prevalence of low anterior resection syndrome and systematic review of risk factors. Int J Surg, 2018, 56: 234-241.
12.	蒲羽, 邱远, 李祥, 等. 直肠癌保肛术后低位前切除综合征发生率、恢复情况及影响因素的回顾性分析. 第三军医大学学报, 2017, 39(10): 1025-1030.
13.	Herrinton LJ, Altschuler A, McMullen CK, et al. Conversations for providers caring for patients with rectal cancer: Comparison of long-term patient-centered outcomes for patients with low rectal cancer facing ostomy or sphincter-sparing surgery. CA Cancer J Clin, 2016, 66(5): 387-397.
14.	Koedam TW, van Ramshorst GH, Deijen CL, et al. Transanal total mesorectal excision (TaTME) for rectal cancer: effects on patient-reported quality of life and functional outcome. Tech Coloproctol, 2017, 21(1): 25-33.
15.	Veltcamp Helbach M, Koedam TWA, Knol JJ, et al. Quality of life after rectal cancer surgery: differences between laparoscopic and transanal total mesorectal excision. Surg Endosc, 2019, 33(1): 79-87.
16.	Bjoern MX, Nielsen S, Perdawood SK. Quality of life after surgery for rectal cancer: a comparison of functional outcomes after transanal and laparoscopic approaches. J Gastrointest Surg, 2019, 23(8): 1623-1630.
17.	Reali C, Keller DS, Penna M, et al. Low anterior resection syndrome: Are we getting to the bottom of the problem with TaTME? Colorectal Dis, 2018, 20: 41.
18.	Turrado-Rodriguez V, Torroella AT, De Lacy OF, et al. Functional outcomes after tatme: Retrospective analysis of quality of life and pelvic function. Dis Colon Rectum, 2018, 61(5): 222.
19.	Williamson ME, Lewis WG, Finan PJ, et al. Recovery of physiologic and clinical function after low anterior resection of the rectum for carcinoma: myth or reality? Dis Colon Rectum, 1995, 38(4): 411-418.
20.	Wallner C, Lange MM, Bonsing BA, et al. Causes of fecal and urinary incontinence after total mesorectal excision for rectal cancer based on cadaveric surgery: a study from the Cooperative Clinical Investigators of the Dutch total mesorectal excision trial. J Clin Oncol, 2008, 26(27): 4466-4472.
21.	罗良弢. 腹腔镜直肠癌根治术中的神经保护. 中华胃肠外科杂志, 2018, 21(5): 513.
22.	Liu Z, Huang M, Kang L, et al. Prognosis and postoperative genital function of function-preservative surgery of pelvic autonomic nerve preservation for male rectal cancer patients. BMC Surg, 2016, 16: 12.
23.	Pontallier A, Denost Q, Van Geluwe B, et al. Potential sexual function improvement by using transanal mesorectal approach for laparoscopic low rectal cancer excision. Surg Endosc, 2016, 30(11): 4924-4933.
24.	Kneist W, Wachter N, Paschold M, et al. Midterm functional results of taTME with neuromapping for low rectal cancer. Tech Coloproctol, 2016, 20(1): 41-49.
25.	Keller DS, Reali C, Penna M, et al. Long-term functional and quality of life outcomes after tatme for rectal cancer. Dis Colon Rectum, 2018, 61(5): 208-209.
26.	Bryant CL, Lunniss PJ, Knowles CH, et al. Anterior resection syndrome. Lancet Oncol, 2012, 13(9): e403-e408.
27.	葛欣, 王锡山. 低位前切除综合征研究进展. 中华胃肠外科杂志, 2011, 14(12): 994-998.
28.	Bittorf B, Stadelmaier U, Göhl J, et al. Functional outcome after intersphincteric resection of the rectum with coloanal anastomosis in low rectal cancer. Eur J Surg Oncol, 2004, 30(3): 260-265.
29.	MatzeI KE, Bittorf B, Gunther K, et al. Rectal resection with low anastomosis: functional outcome. Colorectal Dis, 2003, 5(5): 458-464.
30.	Turrado-Rodriguez V, Torroella AT, De Lacy OF, et al. Anorectal dysfunction after tatme: Manometric and endoanal ultrasound analysis. Dis Colon Rectum, 2018, 61(5): e71.
31.	Elmore U, Fumagalli Romario U, Vignali A, et al. Laparoscopic anterior resection with transanal total mesorectal excision for rectal cancer: preliminary experience and impact on postoperative bowel function. J Laparoendosc Adv Surg Tech A, 2015, 25(5): 364-369.
32.	Mora L, Zarate A, Serra-Aracil X, et al. Functional impairment and quality of life after rectal cancer surgery. Cir Cir, 2018, 86(2): 140-147.
33.	雷跃华, 杨玉辉, 陈文兴, 等. 经肛全直肠系膜切除术与经典腹腔镜全直肠系膜切除术的临床对比研究. 实用医院临床杂志, 2018, 15(4): 101-104.
34.	叶志伟, 陈远光, 胡明, 等. 直肠癌经肛内镜全直肠系膜切除术对肛门功能影响的临床研究. 中国普通外科杂志, 2015, 24(4): 473-477.
35.	窦若虚, 孙伟鹏, 罗双灵, 等. 经肛全直肠系膜切除与腹腔镜全直肠系膜切除术后患者的肠道功能: 基于随机临床研究的比较. 中华胃肠外科杂志, 2019, 22(3): 246-254.
36.	李建升, 孙景仙, 白克运, 等. 直肠癌前切除综合征病因分析及治疗进展. 中国现代普通外科进展, 2018, 21(5): 410-413, 416.
37.	马全民, 申占龙, 刘凡, 等. 经肛全直肠系膜切除与腹腔镜全直肠系膜切除术后肛门功能的比较. 中华结直肠疾病电子杂志, 2018, 7(4): 337-341.
38.	Hanke L, Kauff DW, Lang H, et al. Ano(neo-) rectal function after transanal total mesorectal excision (TaTME) for primary rectal cancer. Eur Surg Res, 2017, 58(suppl. 1): 39.

1. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg, 1982, 69(10): 613-616.
2. 申占龙, 叶颖江, 王杉. 直肠癌全直肠系膜切除术中盆腔植物神经的易损区域及保护. 中华结直肠疾病电子杂志, 2018, 7(1): 8-11.
3. Kneist W, Hanke L, Kauff DW, et al. Surgeons’ assessment of internal anal sphincter nerve supply during TaTME—inbetween expectations and reality. Minim Invasive Ther Allied Technol, 2016, 25(5): 241-246.
4. Chouillard E, Regnier A, Vitte RL, et al. Transanal NOTES total mesorectal excision (TME) in patients with rectal cancer: Is anatomy better preserved? Tech Coloproctol, 2016, 20(8): 537-544.
5. Lacy AM, Adelsdorfer C, Delgado S, et al. Minilaparoscopy-assisted transrectal low anterior resection (LAR): a preliminary study. Surg Endosc, 2013, 27(1): 339-346.
6. Velthuis S, van den Boezem PB, van der Peet DL, et al. Feasibility study of transanal total mesorectal excision. Br J Surg, 2013, 100(6): 828-831.
7. Lacy AM, Tasende MM, Delgado S, et al. Transanal total mesorectal excision for rectal cancer: outcomes after 140 patients. J Am Coll Surg, 2015, 221(2): 415-423.
8. Veltcamp Helbach M, Deijen CL, Velthuis S, et al. Transanal total mesorectal excision for rectal carcinoma: short-term outcomes and experience after 80 cases. Surg Endosc, 2016, 30(2): 464-470.
9. Simillis C, Hompes R, Penna M, et al. A systematic review of transanal total mesorectal excision: is this the future of rectal cancer surgery? Colorectal Dis, 2016, 18(1): 19-36.
10. Deijen CL, Tsai A, Koedam TW, et al. Clinical outcomes and case volume effect of transanal total mesorectal excision for rectal cancer: a systematic review. Tech Coloproctol, 2016, 20(12): 811-824.
11. Croese AD, Lonie JM, Trollope AF, et al. A meta-analysis of the prevalence of low anterior resection syndrome and systematic review of risk factors. Int J Surg, 2018, 56: 234-241.
12. 蒲羽, 邱远, 李祥, 等. 直肠癌保肛术后低位前切除综合征发生率、恢复情况及影响因素的回顾性分析. 第三军医大学学报, 2017, 39(10): 1025-1030.
13. Herrinton LJ, Altschuler A, McMullen CK, et al. Conversations for providers caring for patients with rectal cancer: Comparison of long-term patient-centered outcomes for patients with low rectal cancer facing ostomy or sphincter-sparing surgery. CA Cancer J Clin, 2016, 66(5): 387-397.
14. Koedam TW, van Ramshorst GH, Deijen CL, et al. Transanal total mesorectal excision (TaTME) for rectal cancer: effects on patient-reported quality of life and functional outcome. Tech Coloproctol, 2017, 21(1): 25-33.
15. Veltcamp Helbach M, Koedam TWA, Knol JJ, et al. Quality of life after rectal cancer surgery: differences between laparoscopic and transanal total mesorectal excision. Surg Endosc, 2019, 33(1): 79-87.
16. Bjoern MX, Nielsen S, Perdawood SK. Quality of life after surgery for rectal cancer: a comparison of functional outcomes after transanal and laparoscopic approaches. J Gastrointest Surg, 2019, 23(8): 1623-1630.
17. Reali C, Keller DS, Penna M, et al. Low anterior resection syndrome: Are we getting to the bottom of the problem with TaTME? Colorectal Dis, 2018, 20: 41.
18. Turrado-Rodriguez V, Torroella AT, De Lacy OF, et al. Functional outcomes after tatme: Retrospective analysis of quality of life and pelvic function. Dis Colon Rectum, 2018, 61(5): 222.
19. Williamson ME, Lewis WG, Finan PJ, et al. Recovery of physiologic and clinical function after low anterior resection of the rectum for carcinoma: myth or reality? Dis Colon Rectum, 1995, 38(4): 411-418.
20. Wallner C, Lange MM, Bonsing BA, et al. Causes of fecal and urinary incontinence after total mesorectal excision for rectal cancer based on cadaveric surgery: a study from the Cooperative Clinical Investigators of the Dutch total mesorectal excision trial. J Clin Oncol, 2008, 26(27): 4466-4472.
21. 罗良弢. 腹腔镜直肠癌根治术中的神经保护. 中华胃肠外科杂志, 2018, 21(5): 513.
22. Liu Z, Huang M, Kang L, et al. Prognosis and postoperative genital function of function-preservative surgery of pelvic autonomic nerve preservation for male rectal cancer patients. BMC Surg, 2016, 16: 12.
23. Pontallier A, Denost Q, Van Geluwe B, et al. Potential sexual function improvement by using transanal mesorectal approach for laparoscopic low rectal cancer excision. Surg Endosc, 2016, 30(11): 4924-4933.
24. Kneist W, Wachter N, Paschold M, et al. Midterm functional results of taTME with neuromapping for low rectal cancer. Tech Coloproctol, 2016, 20(1): 41-49.
25. Keller DS, Reali C, Penna M, et al. Long-term functional and quality of life outcomes after tatme for rectal cancer. Dis Colon Rectum, 2018, 61(5): 208-209.
26. Bryant CL, Lunniss PJ, Knowles CH, et al. Anterior resection syndrome. Lancet Oncol, 2012, 13(9): e403-e408.
27. 葛欣, 王锡山. 低位前切除综合征研究进展. 中华胃肠外科杂志, 2011, 14(12): 994-998.
28. Bittorf B, Stadelmaier U, Göhl J, et al. Functional outcome after intersphincteric resection of the rectum with coloanal anastomosis in low rectal cancer. Eur J Surg Oncol, 2004, 30(3): 260-265.
29. MatzeI KE, Bittorf B, Gunther K, et al. Rectal resection with low anastomosis: functional outcome. Colorectal Dis, 2003, 5(5): 458-464.
30. Turrado-Rodriguez V, Torroella AT, De Lacy OF, et al. Anorectal dysfunction after tatme: Manometric and endoanal ultrasound analysis. Dis Colon Rectum, 2018, 61(5): e71.
31. Elmore U, Fumagalli Romario U, Vignali A, et al. Laparoscopic anterior resection with transanal total mesorectal excision for rectal cancer: preliminary experience and impact on postoperative bowel function. J Laparoendosc Adv Surg Tech A, 2015, 25(5): 364-369.
32. Mora L, Zarate A, Serra-Aracil X, et al. Functional impairment and quality of life after rectal cancer surgery. Cir Cir, 2018, 86(2): 140-147.
33. 雷跃华, 杨玉辉, 陈文兴, 等. 经肛全直肠系膜切除术与经典腹腔镜全直肠系膜切除术的临床对比研究. 实用医院临床杂志, 2018, 15(4): 101-104.
34. 叶志伟, 陈远光, 胡明, 等. 直肠癌经肛内镜全直肠系膜切除术对肛门功能影响的临床研究. 中国普通外科杂志, 2015, 24(4): 473-477.
35. 窦若虚, 孙伟鹏, 罗双灵, 等. 经肛全直肠系膜切除与腹腔镜全直肠系膜切除术后患者的肠道功能: 基于随机临床研究的比较. 中华胃肠外科杂志, 2019, 22(3): 246-254.
36. 李建升, 孙景仙, 白克运, 等. 直肠癌前切除综合征病因分析及治疗进展. 中国现代普通外科进展, 2018, 21(5): 410-413, 416.
37. 马全民, 申占龙, 刘凡, 等. 经肛全直肠系膜切除与腹腔镜全直肠系膜切除术后肛门功能的比较. 中华结直肠疾病电子杂志, 2018, 7(4): 337-341.
38. Hanke L, Kauff DW, Lang H, et al. Ano(neo-) rectal function after transanal total mesorectal excision (TaTME) for primary rectal cancer. Eur Surg Res, 2017, 58(suppl. 1): 39.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research progress of functional outcomes secondary to transanal total mesorectal excision

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