Erschienen in:
01.01.2016 | Original Article
Midterm functional results of taTME with neuromapping for low rectal cancer
verfasst von:
W. Kneist, N. Wachter, M. Paschold, D. W. Kauff, A. D. Rink, H. Lang
Erschienen in:
Techniques in Coloproctology
|
Ausgabe 1/2016
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Abstract
Background
Information on functional outcomes after laparoscopic-assisted transanal total mesorectal excision (taTME) is limited. This study analyzed the functional results in patients with low rectal cancer.
Methods
Ten consecutive patients (nine males) undergoing electrophysiologically controlled nerve-sparing taTME were investigated prospectively and asked to complete functional questionnaires [the International Prostate Symptom Score (IPSS), International Index of Erectile Function, Female Sexual Function Index, Wexner score, and low anterior resection syndrome (LARS) score]. Bladder function was also assessed according to residual urine volume. Preoperative function was compared to the functional outcome 3 and 6 months, and 9 months if eligible, after stoma closure or surgery in the absence of a diverting stoma.
Results
Prior to therapy, urinary and sexual function was impaired in 40 and 60 % of patients, respectively. None of the patients developed pathological residual urine volumes after at least unilateral functional pelvic nerve-sparing. Median IPSS was lower than preoperative scores (p > 0.05). Two males with incomplete nerve preservation were considered impotent during a median follow-up of 15 months (range 6–20 months). The female was judged to be sexually inactive. The median Wexner score was 1 (range 0–7) prior to any therapy and increased to 7 (range 0–15) at 6 months (p = 0.029), with 40 % of patients categorized as having no LARS and 50 % minor LARS. The median LARS score was 28 (range 9–38) at 3 months and 26 (range 9–32) at 6 months (p = 0.165).
Conclusions
Despite a small sample size and confounding factors, data indicate that taTME has the potential to preserve continence, sufficient bowel function, and urogenital function.