TY - JOUR
T1 - Functional complaints and quality of life after transanal total mesorectal excision
T2 - a meta-analysis
AU - van der Heijden, J. A.G.
AU - Koëter, T.
AU - Smits, L. J.H.
AU - Sietses, C.
AU - Tuynman, J. B.
AU - Maaskant-Braat, A. J.G.
AU - Klarenbeek, B. R.
AU - de Wilt, J. H.W.
N1 - Funding Information: The authors thank Professor K. Gurusamy from University College London for the teaching of his systematic review course and helpful insights in conducting this systematic review. Preregistration of this study was undertaken, which included an analysis plan for the primary outcome measures (PROSPERO; CRD42019126975). Disclosure: The authors declare no conflict of interest. Publisher Copyright: © 2020 BJS Society Ltd published by John Wiley & Sons Ltd Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Background: Total mesorectal excision (TME) gives excellent oncological results in rectal cancer treatment, but patients may experience functional problems. A novel approach to performing TME is by single-port transanal minimally invasive surgery. This systematic review evaluated the functional outcomes and quality of life after transanal and laparoscopic TME. Methods: A comprehensive search in PubMed, the Cochrane Library, Embase and the trial registers was conducted in May 2019. PRISMA guidelines were used. Data for meta-analysis were pooled using a random-effects model. Results: A total of 11 660 studies were identified, from which 14 studies and six conference abstracts involving 846 patients (599 transanal TME, 247 laparoscopic TME) were included. A substantial number of patients experienced functional problems consistent with low anterior resection syndrome (LARS). Meta-analysis found no significant difference in major LARS between the two approaches (risk ratio 1·13, 95 per cent c.i. 0·94 to 1·35; P = 0·18). However, major heterogeneity was present in the studies together with poor reporting of functional baseline assessment. Conclusion: No differences in function were observed between transanal and laparoscopic TME.
AB - Background: Total mesorectal excision (TME) gives excellent oncological results in rectal cancer treatment, but patients may experience functional problems. A novel approach to performing TME is by single-port transanal minimally invasive surgery. This systematic review evaluated the functional outcomes and quality of life after transanal and laparoscopic TME. Methods: A comprehensive search in PubMed, the Cochrane Library, Embase and the trial registers was conducted in May 2019. PRISMA guidelines were used. Data for meta-analysis were pooled using a random-effects model. Results: A total of 11 660 studies were identified, from which 14 studies and six conference abstracts involving 846 patients (599 transanal TME, 247 laparoscopic TME) were included. A substantial number of patients experienced functional problems consistent with low anterior resection syndrome (LARS). Meta-analysis found no significant difference in major LARS between the two approaches (risk ratio 1·13, 95 per cent c.i. 0·94 to 1·35; P = 0·18). However, major heterogeneity was present in the studies together with poor reporting of functional baseline assessment. Conclusion: No differences in function were observed between transanal and laparoscopic TME.
UR - http://www.scopus.com/inward/record.url?scp=85081208414&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/bjs.11566
DO - https://doi.org/10.1002/bjs.11566
M3 - Review article
C2 - 32154594
SN - 0007-1323
VL - 107
SP - 489
EP - 498
JO - British Journal of Surgery
JF - British Journal of Surgery
IS - 5
ER -