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经肛门全直肠系膜切除术:刚性平台与柔性平台的手术可行性及短期肿瘤学结局

Operative Feasibility and Short-Term Oncologic Outcome of Rigid Versus Flexible Platforms in Transanal Total Mesorectal Excision.

作者信息

Zuhdy Mohammad, Metwally Islam H, Eldamshety Osama, Roshdy Sameh

机构信息

Surgical Oncology Unit, Oncology Center Mansoura University (OCMU), Geehan Street, Mansoura, 35516 Egypt.

Department of Gastrointestinal Surgery, IRCCS San Raffaele, University Vita e Salute, San Raffaele Hospital and San Raffaele Vita-Salute University, Via Olgettina, 60 20132 Milan, Italy.

出版信息

Indian J Surg Oncol. 2021 Mar;12(1):222-228. doi: 10.1007/s13193-021-01282-z. Epub 2021 Feb 9.

Abstract

Several transanal platforms were used to perform transanal total mesorectal excision (TaTME). They can be classified into rigid reusable platforms or flexible single-use platforms. The choice of transanal platform usually depends on the availability and the surgeon's discretion. To the best of our knowledge, this is the first study to compare the operative and oncologic outcome of flexible and rigid platforms during TaTME. This is a retrospective cohort study in which rectal cancer patients operated by TaTME in two tertiary centers from June 2013 to April 2019 were included. They were classified into two groups according to the platform used either the rigid platform group ( = 17) or the flexible platform ( = 14). Operative feasibility and short-term oncologic data were analyzed and reported. A total number of 31 patients were divided into either the rigid platform group ( = 17) versus the flexible platform one ( = 14). Shorter operating time, less blood loss, better TME specimens, and lymph node yield were reported in the flexible platform group. Flexible platforms were associated with better operative outcomes. Although there were no differences in circumferential and distal margins between the two groups, better TME specimens' quality and lymph node yield were reported in the flexible platform group. Future prospective trials are encouraged to provide better evidence.

摘要

使用了几种经肛门平台来进行经肛门全直肠系膜切除术(TaTME)。它们可分为刚性可重复使用平台或柔性一次性使用平台。经肛门平台的选择通常取决于其可用性和外科医生的判断。据我们所知,这是第一项比较TaTME期间柔性和刚性平台的手术及肿瘤学结果的研究。这是一项回顾性队列研究,纳入了2013年6月至2019年4月在两个三级中心接受TaTME手术的直肠癌患者。根据所使用的平台将他们分为两组,即刚性平台组(n = 17)或柔性平台组(n = 14)。分析并报告了手术可行性和短期肿瘤学数据。总共31例患者被分为刚性平台组(n = 17)和柔性平台组(n = 14)。柔性平台组报告了更短的手术时间、更少的失血、更好的TME标本和更高的淋巴结收获量。柔性平台与更好的手术结果相关。尽管两组之间的环周切缘和远端切缘没有差异,但柔性平台组报告了更好的TME标本质量和更高的淋巴结收获量。鼓励未来进行前瞻性试验以提供更好的证据。

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