NYMC Faculty Publications
Does Transanal Total Mesorectal Excision of Rectal Cancer Improve Histopathology Metrics and/or Complication Rates? A Meta-Analysis
DOI
10.1016/j.suronc.2019.05.012
Journal Title
Surgical Oncology
First Page
47
Last Page
51
Document Type
Article
Publication Date
September 2019
Department
Surgery
Keywords
Circumferential resection margin, Rectal cancer, Robotic surgery, Total mesorectal excision, Transanal surgery
Disciplines
Medicine and Health Sciences
Abstract
BACKGROUND: The aim of this meta-analysis was to determine whether transanal total mesorectal excision (taTME) improves histopathology metrics and/or complication rates when compared to robotic total mesorectal excision (R-TME) of resectable rectal cancer. METHODS: MEDLINE, Pubmed, Cochrane Library, and Scopus were systematically searched by two independent researchers. Six observational studies totaling 1,572 patients (811 taTME; 761R-TME) were included after screening 14 potentially eligible records. Mantel-Haenszel method using odds ratios with 95% confidence intervals (OR (95%CI)) and inverse variance with mean difference with 95% confidence intervals (MD (95%CI)) as an effect measure for dichotomous and continuous variables, respectively, was employed for meta-analysis. Statistical heterogeneity among effect estimates was evaluated using I(2) and Tau(2). RESULTS: Circumferential resection margin (CRM) involvement rates (3.8% taTME; 5.3% R-TME) did not differ [OR (95%CI)=0.86 (0.35, 2.15); p=0.75] with low among-study heterogeneity (I(2)=21%). Complication rates (35.4% taTME; 32.3% R-TME) did not differ [OR (95%CI)=0.92 (0.64, 1.32); p=0.65], although with moderate among-study heterogeneity (I(2)=40%). CRM involvement [OR (95%CI)=0.76 (0.40, 1.43); p=0.40] and complication rates [OR (95%CI)=0.84 (0.59, 1.21); p=0.35] did not significantly differ in subgroup meta-analysis including mid- and low rectal cancer. Distal resection margin (mm) did not significantly differ between the interventions [MD (95%CI)=-0.41 (-1.29, 0.47); p=0.37]. CONCLUSIONS: This meta-analysis found that taTME of rectal cancer does not improve histopathology metrics and complication rates when compared to R-TME.
Recommended Citation
Gachabayov, M., Tulina, I., Bergamaschi, R., & Tsarkov, P. (2019). Does Transanal Total Mesorectal Excision of Rectal Cancer Improve Histopathology Metrics and/or Complication Rates? A Meta-Analysis. Surgical Oncology, 30, 47-51. https://doi.org/10.1016/j.suronc.2019.05.012
