Department of Surgery, Copenhagen University Hospital Herlev, Herlev, Denmark.
Danish Colorectal Cancer Group (DCCG.dk, Copenhagen, Denmark.
Colorectal Dis. 2021 Apr;23(4):834-842. doi: 10.1111/codi.15454. Epub 2020 Dec 7.
The aim of this study was to evaluate the short-term surgical and oncological outcomes after transanal total mesorectal excision (TaTME) for rectal cancer during the implementation phase of this procedure in Denmark.
This is a retrospective review of prospectively recorded data. Registration was initiated by the Scientific Council of the Danish Colorectal Cancer Group (DCCG.dk) in order to assess the quality of care during the implementation of TaTME. Pre-, intra- and postoperative data including early recurrences were recorded at the operating centres.
From August 2016 to April 2019, 115 TaTME procedures were registered. Patients were predominantly male (74%) with mid-rectal (88%) tumours. The level of surgical complications was comparable to previous nationwide results. Anastomotic leakage occurred in 6/109 (5.5%). One urethral injury occurred. The plane of dissection was mesorectal in 60% of cases, intramesorectal in 28% and muscularis in 12%. Nonmicroradicality was seen in 8% (R1, 6%; R2, 2%). Four local recurrences occurred after a median of 23 months of follow-up. One of these was multifocal.
In an implementation phase where patient selection is expected, surgical and oncological results after TaTME were comparable to those of other approaches reported in the literature.
本研究旨在评估丹麦实施经肛门全直肠系膜切除术(TaTME)治疗直肠癌的短期手术和肿瘤学结果。
这是一项前瞻性记录数据的回顾性研究。登记工作由丹麦结直肠肿瘤学研究组(DCCG.dk)的科学委员会发起,以评估 TaTME 实施期间的护理质量。在手术中心记录了术前、术中及术后数据,包括早期复发。
从 2016 年 8 月至 2019 年 4 月,共登记了 115 例 TaTME 手术。患者主要为男性(74%),肿瘤位于直肠中段(88%)。手术并发症的发生率与之前全国范围内的结果相当。吻合口漏发生在 109 例中的 6 例(5.5%)。发生 1 例尿道损伤。60%的病例解剖平面为直肠系膜,28%为直肠固有肌层,12%为肌层。非微放射学表现为 8%(R1,6%;R2,2%)。4 例局部复发发生在中位随访 23 个月后。其中 1 例为多灶性。
在预期进行患者选择的实施阶段,TaTME 后的手术和肿瘤学结果与文献报道的其他方法相当。