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Erschienen in: Updates in Surgery 1/2021

07.11.2020 | Original Article

One-year evaluation of anorectal functionality and quality of life in patients affected by mid-to-low rectal cancer treated with transanal total mesorectal excision

verfasst von: Veronica De Simone, Roberto Persiani, Alberto Biondi, Francesco Litta, Angelo Parello, Paola Campennì, Raffaele Orefice, Angelo Marra, Alessandra Costa, Domenico D’Ugo, Carlo Ratto

Erschienen in: Updates in Surgery | Ausgabe 1/2021

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Abstract

Surgery of mid-to-low rectal cancer is still considered challenging. Transanal total mesorectal excision has been proposed to facilitate the mesorectal dissection, gain sphincter-saving procedures, and reduce functional sequelae. Few studies have investigated long-term functional outcomes and patients’ quality of life. The aim of this study was to compare functional outcomes and quality of life before and after transanal total mesorectal excision in 1-year follow-up. Between February 2016 and April 2019, 51 patients with mid- or low rectal cancer undergoing transanal total mesorectal excision at Fondazione Policlinico Universitario “A. Gemelli” were enrolled. Neoadjuvant radiochemotherapy was administered to locally advanced cancers. Before and after the surgical procedure, patients were examined collecting clinical data, LARS score, CCFIS, SF36 and FIQL, performing anorectal manometry and endoanal ultrasonography. Thirty-three patients were eligible and completed the 12 months follow-up. After treatment, six patients (18.2%) had minor or major LARS. A mild but significant increase of CCFIS was documented. Only the mean resting pressure significantly decreased at follow-up. No sphincter lesions were documented. FIQL assessment showed significant reduction of lifestyle, coping/behaviour, and embarrassment, while an increase of general health was assessed by SF36. At both uni- and multivariate analyses the neoadjuvant radiochemotherapy had a not negligible impact. Transanal total mesorectal excision represents a safe approach to patients treated for mid- or low rectal cancer. The functional sequelae can be limited in severity, with a low incidence of minor/major LARS, particularly faecal incontinence. These results are comparable to those obtained by the conventional total mesorectal excision.
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Metadaten
Titel
One-year evaluation of anorectal functionality and quality of life in patients affected by mid-to-low rectal cancer treated with transanal total mesorectal excision
verfasst von
Veronica De Simone
Roberto Persiani
Alberto Biondi
Francesco Litta
Angelo Parello
Paola Campennì
Raffaele Orefice
Angelo Marra
Alessandra Costa
Domenico D’Ugo
Carlo Ratto
Publikationsdatum
07.11.2020
Verlag
Springer International Publishing
Erschienen in
Updates in Surgery / Ausgabe 1/2021
Print ISSN: 2038-131X
Elektronische ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-020-00919-y

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