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Morbidity, Mortality, and Pathologic Outcomes of Transanal Versus Laparoscopic Total Mesorectal Excision for Rectal Cancer Short-term Outcomes From a Multicenter Randomized Controlled Trial

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作者：
Liu Huashan[1] * ; Zeng Ziwei[1] ; Zhang Hong[2] ; Wu Miao[3] ; Ma Dan[4] ; Wang Quan[5] ; Xie Ming[6] ; Xu Qing[7] ; Ouyang Jun[8] ; Xiao Yi[9] ; Song Yongchun[10] ; Feng Bo[11] ; Xu Qingwen[12] ; Wang Yanan[13] ; Zhang Yi[14] ; Hao Yuantao[15] ; Luo Shuangling[1] ; Zhang Xingwei[1] ; Yang Zuli[1] ; Peng Junsheng[1] ; Wu Xiaojian[1] ; Ren Donglin[1] ; Huang Meijin[1] ; Lan Ping[1] ; Tong Weidong[16] ; Ren Mingyang[17] ; Wang Jianping[1] ; Kang Liang[1,*1] ;
机构： [1]Department of Colorectal Surgery and Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China. [2]Department of Colorectal Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China. [3]Department of Gastrointestinal Surgery, The Second People's Hospital of Yibin, Yibin, Sichuan Province, China. [4]Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China. [5]Department of Gastrointestinal Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, China. [6]Department of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China. [7]Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. [8]Department of Gastrointestinal Surgery, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province, China. [9]Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China. [10]Department of Gastrointestinal Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xian, Shanxi Province, China. [11]Department of Gastrointestinal Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. [12]Department of Gastrointestinal Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, China. [13]Department of Gastrointestinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China. [14]Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China. [15]Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong Province, China. [16]Department of General Surgery, Daping Hospital, Army Medical University, Chongqing, China. [17]Department of Gastrointestinal Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China.
出处：
DOI： 10.1097/SLA.0000000000005523
ISSN：

关键词： rectal cancer taTME morbidity mortality

摘要：
To determine the morbidity, mortality, and pathologic outcomes of transanal total mesorectal resection (taTME) versus laparoscopic total mesorectal excision (laTME) among patients with rectal cancer with clinical stage I to III rectal cancer below the peritoneal reflection.Studies with sufficient numbers of patients allowing clinical acceptance of taTME for rectal cancer are lacking. Thus, we launched a randomized clinical trial to compare the safety and efficacy of taTME versus laTME.A randomized, open-label, phase 3, noninferiority trial was performed at 16 different hospitals in 10 Chinese provinces. The primary endpoints were 3-year disease-free survival and 5-year overall survival. The morbidity and mortality within 30 days after surgery, and pathologic outcomes were compared based on a modified intention-to-treat principle; this analysis was preplanned.Between April 13, 2016, and June 1, 2021, 1115 patients were randomized 1:1 to receive taTME or laTME. After exclusion of 26 cases, modified intention-to-treat set of taTME versus laTME groups included 544 versus 545 patients. There were no significant differences between taTME and laTME groups in intraoperative complications [26 (4.8%) vs 33 (6.1%); difference, -1.3%; 95% confidence interval (CI), -4.2% to 1.7%; P=0.42], postoperative morbidity [73 (13.4%) vs 66 (12.1%); difference, 1.2%; 95% CI, -2.8% to 5.2%; P=0.53), or mortality [1 (0.2%) vs 1 (0.2%)]. Successful resection occurred in 538 (98.9%) versus 538 (98.7%) patients in taTME versus laTME groups (difference, 0.2%; 95% CI, -1.9% to 2.2%; P>0.99).Experienced surgeons can safely perform taTME in selected patients with rectal cancer.Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.

基金：
This work was supported by the Sun Yat-sen University Clinical Research 5010 Program (201 6005), Science and Technology Projects in Guangzhou (202206010062), China Postdoctoral Science Foundation (202 1M703723), and Guangdong Basic and Applied Basic Research Foundation (2021A1515111011).
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出版当年[2023]版：
大类 | 1 区 医学
小类 | 1 区 外科
最新[2023]版：
大类 | 1 区 医学
小类 | 1 区 外科
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出版当年[2023]版：
Q1 SURGERY
最新[2023]版：
Q1 SURGERY

影响因子： 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

第一作者：
第一作者机构： [1]Department of Colorectal Surgery and Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
通讯作者：
通讯机构： [1]Department of Colorectal Surgery and Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China. [*1]Department of Colorectal Surgery and Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China.
推荐引用方式(GB/T 7714)：
Liu Huashan,Zeng Ziwei,Zhang Hong,et al.Morbidity, Mortality, and Pathologic Outcomes of Transanal Versus Laparoscopic Total Mesorectal Excision for Rectal Cancer Short-term Outcomes From a Multicenter Randomized Controlled Trial[J].ANNALS OF SURGERY.2023,277(1):1-6.doi:10.1097/SLA.0000000000005523.
APA：
Liu Huashan,Zeng Ziwei,Zhang Hong,Wu Miao,Ma Dan...&Kang Liang.(2023).Morbidity, Mortality, and Pathologic Outcomes of Transanal Versus Laparoscopic Total Mesorectal Excision for Rectal Cancer Short-term Outcomes From a Multicenter Randomized Controlled Trial.ANNALS OF SURGERY,277,(1)
MLA：
Liu Huashan,et al."Morbidity, Mortality, and Pathologic Outcomes of Transanal Versus Laparoscopic Total Mesorectal Excision for Rectal Cancer Short-term Outcomes From a Multicenter Randomized Controlled Trial".ANNALS OF SURGERY 277..1(2023):1-6

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