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Transanal total mesorectal excision (TaTME) for rectal cancer : effects on patient-reported quality of life and functional outcome

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Abstract
Transanal total mesorectal excision (TaTME) has rapidly become an important component of the treatment of rectal cancer surgery. Cohort studies have shown feasibility concerning procedure, specimen quality and morbidity. However, concerns exist about quality of life and ano(neo)rectal function. The aim of this study was to prospectively evaluate quality of life in patients following TaTME for rectal cancer with anastomosis. Consecutive patients who underwent restorative TaTME surgery for rectal adenocarcinoma in an academic teaching center with tertiary referral function were evaluated. Validated questionnaires were prospectively collected. Quality of life was assessed by the EuroQol 5D (EQ-5D), European Organization for Research and Treatment of Cancer's QLQ-C30 and QLQ-CR29 and low anterior resection syndrome (LARS) scale. Outcomes of the questionnaires at 1 and 6 months were compared with preoperative (baseline) values. Thirty patients after restorative TaTME for rectal cancer were included. Deterioration for all domains was mainly observed at 1 month after surgery compared to baseline, but most outcomes had returned to baseline at 6 months. Social function and anal pain remained significantly worse at 6 months. Major LARS (score > 30) was 33% at 6 months after ileostomy closure. No end colostomies were required. TaTME is associated with acceptable quality of life and functional outcome at 6 months after surgery comparable to published results after conventional laparoscopic low anterior resection.
Keywords
Rectum, Cancer, Surgery, TaTME, Quality of life, PROMs, LOW ANTERIOR RESECTION, ABDOMINOPERINEAL RESECTION, BOWEL DYSFUNCTION, RANDOMIZED-TRIAL, OPEN SURGERY, IMPACT

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MLA
Koedam, T. W. A., et al. “Transanal Total Mesorectal Excision (TaTME) for Rectal Cancer : Effects on Patient-Reported Quality of Life and Functional Outcome.” TECHNIQUES IN COLOPROCTOLOGY, vol. 21, no. 1, 2017, pp. 25–33, doi:10.1007/s10151-016-1570-z.
APA
Koedam, T. W. A., van Ramshorst, G., Deijen, C. L., Elfrink, A. K. E., Meijerink, W. J. H. J., Bonjer, H. J., … Tuynman, J. B. (2017). Transanal total mesorectal excision (TaTME) for rectal cancer : effects on patient-reported quality of life and functional outcome. TECHNIQUES IN COLOPROCTOLOGY, 21(1), 25–33. https://doi.org/10.1007/s10151-016-1570-z
Chicago author-date
Koedam, T. W. A., Gabriëlle van Ramshorst, C. L. Deijen, A. K. E. Elfrink, W. J. H. J. Meijerink, H. J. Bonjer, C. Sietses, and J. B. Tuynman. 2017. “Transanal Total Mesorectal Excision (TaTME) for Rectal Cancer : Effects on Patient-Reported Quality of Life and Functional Outcome.” TECHNIQUES IN COLOPROCTOLOGY 21 (1): 25–33. https://doi.org/10.1007/s10151-016-1570-z.
Chicago author-date (all authors)
Koedam, T. W. A., Gabriëlle van Ramshorst, C. L. Deijen, A. K. E. Elfrink, W. J. H. J. Meijerink, H. J. Bonjer, C. Sietses, and J. B. Tuynman. 2017. “Transanal Total Mesorectal Excision (TaTME) for Rectal Cancer : Effects on Patient-Reported Quality of Life and Functional Outcome.” TECHNIQUES IN COLOPROCTOLOGY 21 (1): 25–33. doi:10.1007/s10151-016-1570-z.
Vancouver
1.
Koedam TWA, van Ramshorst G, Deijen CL, Elfrink AKE, Meijerink WJHJ, Bonjer HJ, et al. Transanal total mesorectal excision (TaTME) for rectal cancer : effects on patient-reported quality of life and functional outcome. TECHNIQUES IN COLOPROCTOLOGY. 2017;21(1):25–33.
IEEE
[1]
T. W. A. Koedam et al., “Transanal total mesorectal excision (TaTME) for rectal cancer : effects on patient-reported quality of life and functional outcome,” TECHNIQUES IN COLOPROCTOLOGY, vol. 21, no. 1, pp. 25–33, 2017.
@article{8658595,
  abstract     = {{Transanal total mesorectal excision (TaTME) has rapidly become an important component of the treatment of rectal cancer surgery. Cohort studies have shown feasibility concerning procedure, specimen quality and morbidity. However, concerns exist about quality of life and ano(neo)rectal function. The aim of this study was to prospectively evaluate quality of life in patients following TaTME for rectal cancer with anastomosis.

Consecutive patients who underwent restorative TaTME surgery for rectal adenocarcinoma in an academic teaching center with tertiary referral function were evaluated. Validated questionnaires were prospectively collected. Quality of life was assessed by the EuroQol 5D (EQ-5D), European Organization for Research and Treatment of Cancer's QLQ-C30 and QLQ-CR29 and low anterior resection syndrome (LARS) scale. Outcomes of the questionnaires at 1 and 6 months were compared with preoperative (baseline) values.

Thirty patients after restorative TaTME for rectal cancer were included. Deterioration for all domains was mainly observed at 1 month after surgery compared to baseline, but most outcomes had returned to baseline at 6 months. Social function and anal pain remained significantly worse at 6 months. Major LARS (score > 30) was 33% at 6 months after ileostomy closure. No end colostomies were required.

TaTME is associated with acceptable quality of life and functional outcome at 6 months after surgery comparable to published results after conventional laparoscopic low anterior resection.}},
  author       = {{Koedam, T. W. A. and van Ramshorst, Gabriëlle and Deijen, C. L. and Elfrink, A. K. E. and Meijerink, W. J. H. J. and Bonjer, H. J. and Sietses, C. and Tuynman, J. B.}},
  issn         = {{1123-6337}},
  journal      = {{TECHNIQUES IN COLOPROCTOLOGY}},
  keywords     = {{Rectum,Cancer,Surgery,TaTME,Quality of life,PROMs,LOW ANTERIOR RESECTION,ABDOMINOPERINEAL RESECTION,BOWEL DYSFUNCTION,RANDOMIZED-TRIAL,OPEN SURGERY,IMPACT}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{25--33}},
  title        = {{Transanal total mesorectal excision (TaTME) for rectal cancer : effects on patient-reported quality of life and functional outcome}},
  url          = {{http://dx.doi.org/10.1007/s10151-016-1570-z}},
  volume       = {{21}},
  year         = {{2017}},
}

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