• Br J Surg · Aug 2021

    Multicenter Study

    Transanal total mesorectal excision and low anterior resection syndrome.

    • J A G van der Heijden, S M Qaderi, R Verhoeven, J A E Custers, B R Klarenbeek, Maaskant-BraatA J GAJGDepartment of Surgical Oncology, Máxima Medical Centre, Veldhoven, the Netherlands., de WiltJ H WJHW0000-0001-6773-9668Department of Surgical Oncology, Radboud Institute for Health Science (RIHS), Radboud University Medical Centre, Nijmegen, the Netherlands., and PLCRC group.
    • Department of Surgical Oncology, Radboud Institute for Health Science (RIHS), Radboud University Medical Centre, Nijmegen, the Netherlands.
    • Br J Surg. 2021 Aug 19; 108 (8): 991-997.

    BackgroundBowel dysfunction after rectal cancer surgery is common, with some experiencing low anterior resection syndrome (LARS) is common after rectal cancer surgery. This study examined if transanal total mesorectal excision (TaTME) has a similar risk of LARS and altered quality of life (QoL) as patients who undergo low anterior resection (LAR).MethodsPatients who underwent TaTME or traditionally approached total mesorectal excision in a prospective colorectal cancer cohort study (2014-2019) were propensity score matched in a 1 : 1 ratio. LARS and QoL scores were assessed before and after surgery with a primary endpoint of major LARS at 12 months analysed for possible association between factors by logistic regression.ResultsOf 61 TaTME and 317 LAR patients eligible, 55 from each group were propensity score matched. Higher LARS scores (30.6 versus 25.4, P = 0.010) and more major LARS (65 versus 42 per cent, P = 0.013; OR 2.64, 95 per cent c.i. 1.22 to 5.71) were reported after TaTME. Additionally, QoL score differences (body image, bowel frequency, and embarrassment) were worse in the TaTME group.ConclusionsTaTME may be associated with more severe bowel dysfunction than traditional approaches to rectal cancer.© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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