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Abstract
Background: Low anterior resection syndrome (LARS) is a defecation disorder that frequently occurs after a low anterior resection (LAR) with a total mesorectal excision (TME). The transanal TME for middle-low rectal cancer eliminates the difficulties encountered when approaching in a narrow pelvis. However, the effect of the transanal approach on functional outcomes is unknown. We study the effect of the TaTME method on functional outcomes by comparing the LARS score between the laparoscopic approach (LA) and TaTME in patients with rectal cancer. Methods: We retrospectively studied 76 patients (n = 38 LA, n = 38 TaTME) with rectal cancer. We reviewed the medical records and follow-up visits to get LARS score 6 months after rectal resection or protective ileostomy closure. Results: At the 6 month follow-up, 80% of the patients had LARS symptoms (44% minor LARS and 36% major LARS). LARS scores were not significantly related with the neo-adjuvant radiotherapy. The mean distance of the anastomosis from the anal verge was 4.0 ± 2.0 cm. The TaTME group had significantly lower anastomoses compared to the LA group (4.0 ± 2.0 compared to 5.0 ± 2.0 cm, p <0.001). A univariable analysis showed significantly higher LARS scores in theTaTME group compared to the LA group (mean LARS: 29 vs. 25, p = 0.040). However, a multivariable regression analysis, corrected for neoadjuvant treatment, anastomosis distance from the anal verge, anastomotic leak rate, and body mass index, indicated that we could rule out a significant negative effect of TaTME on the LARS score (p = 0.359). We also found a significant relationship between the LARS score and the distance of the anastomosis from the anal verge (p = 0.026). Conclusion: Most patients in this study exhibited some LARS symptoms after rectal cancer resection. Although the anastomose in TaTME were lower than in the LA group, TaTME was not associated with LARS at 6 months after the protective ileostomy closure
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| Published | 27-04-2021 | |
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| Issue | No. 68 (2021) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.2021.68.15 | |
| Keywords | Hội chứng cắt trước thấp, Cắt toàn bộ trực tràng qua ngã hậu môn, Cắt trực tràng bằng phẫu thuật nội soi Rectal cancer, total mesorectal excision, LARS score |
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