Yanic Ammann, Marie Klein, Lukas Marti, Rene Warschkow, Lennard Ströse, Moritz Sparn, Tarkan Jäger, Stephan Bischofberger, Walter Brunner
{"title":"经肛门全肠系膜切除术（taTME）是否比传统的TME有更好的生活质量和功能结局？回顾性倾向评分调整队列研究。","authors":"Yanic Ammann, Marie Klein, Lukas Marti, Rene Warschkow, Lennard Ströse, Moritz Sparn, Tarkan Jäger, Stephan Bischofberger, Walter Brunner","doi":"10.1007/s00423-025-03724-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The improved prognosis of rectal cancer through modern therapeutic approaches raises questions regarding quality of life (QoL) and functional outcomes. In this study, we compared post-transanal total mesorectal excision (taTME) short- and long-term QoL and functional outcomes with those after abdominal TME (abTME).</p><p><strong>Methods: </strong>Prospective data from patients who underwent elective taTME or abTME for stage I-III rectal cancer followed by anastomosis were retrospectively propensity score-adjusted. The primary endpoint, QoL, was assessed with the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30). Functional outcomes were the secondary endpoints.</p><p><strong>Results: </strong>Among 494 patients during 2013-2022, 187 patients who underwent taTME and 62 patients who underwent abTME were included. QoL was worse after taTME at isolated time points: overall QoL (after 3 years: 72 vs. 82 points, p = 0.017) and QLQ-total (after 3 years: 81 vs. 87 points, p = 0.028; after 4 years: 82 vs. 89 points, p = 0.012). After propensity score matching, the between-group differences were still significant but smaller: overall QoL - 6 points, p = 0.021; QLQ-total - 5 points, p = 0.026.</p><p><strong>Conclusion: </strong>The differences reported at isolated time points have questionable clinical relevance. Therefore, taTME and traditional abTME seem to have comparable long-term QoL and functional outcomes.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, NCT06505863, https://clinicaltrials.gov/search?id=NCT06505863 .</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"149"},"PeriodicalIF":2.1000,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043741/pdf/","citationCount":"0","resultStr":"{\"title\":\"Does transanal total mesorectal excision (taTME) result in better quality of life and functional outcomes than traditional TME does? A retrospective propensity score-adjusted cohort study.\",\"authors\":\"Yanic Ammann, Marie Klein, Lukas Marti, Rene Warschkow, Lennard Ströse, Moritz Sparn, Tarkan Jäger, Stephan Bischofberger, Walter Brunner\",\"doi\":\"10.1007/s00423-025-03724-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The improved prognosis of rectal cancer through modern therapeutic approaches raises questions regarding quality of life (QoL) and functional outcomes. In this study, we compared post-transanal total mesorectal excision (taTME) short- and long-term QoL and functional outcomes with those after abdominal TME (abTME).</p><p><strong>Methods: </strong>Prospective data from patients who underwent elective taTME or abTME for stage I-III rectal cancer followed by anastomosis were retrospectively propensity score-adjusted. The primary endpoint, QoL, was assessed with the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30). Functional outcomes were the secondary endpoints.</p><p><strong>Results: </strong>Among 494 patients during 2013-2022, 187 patients who underwent taTME and 62 patients who underwent abTME were included. QoL was worse after taTME at isolated time points: overall QoL (after 3 years: 72 vs. 82 points, p = 0.017) and QLQ-total (after 3 years: 81 vs. 87 points, p = 0.028; after 4 years: 82 vs. 89 points, p = 0.012). After propensity score matching, the between-group differences were still significant but smaller: overall QoL - 6 points, p = 0.021; QLQ-total - 5 points, p = 0.026.</p><p><strong>Conclusion: </strong>The differences reported at isolated time points have questionable clinical relevance. Therefore, taTME and traditional abTME seem to have comparable long-term QoL and functional outcomes.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, NCT06505863, https://clinicaltrials.gov/search?id=NCT06505863 .</p>\",\"PeriodicalId\":17983,\"journal\":{\"name\":\"Langenbeck's Archives of Surgery\",\"volume\":\"410 1\",\"pages\":\"149\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-04-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043741/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Langenbeck's Archives of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00423-025-03724-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Langenbeck's Archives of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00423-025-03724-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Does transanal total mesorectal excision (taTME) result in better quality of life and functional outcomes than traditional TME does? A retrospective propensity score-adjusted cohort study.
Purpose: The improved prognosis of rectal cancer through modern therapeutic approaches raises questions regarding quality of life (QoL) and functional outcomes. In this study, we compared post-transanal total mesorectal excision (taTME) short- and long-term QoL and functional outcomes with those after abdominal TME (abTME).
Methods: Prospective data from patients who underwent elective taTME or abTME for stage I-III rectal cancer followed by anastomosis were retrospectively propensity score-adjusted. The primary endpoint, QoL, was assessed with the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30). Functional outcomes were the secondary endpoints.
Results: Among 494 patients during 2013-2022, 187 patients who underwent taTME and 62 patients who underwent abTME were included. QoL was worse after taTME at isolated time points: overall QoL (after 3 years: 72 vs. 82 points, p = 0.017) and QLQ-total (after 3 years: 81 vs. 87 points, p = 0.028; after 4 years: 82 vs. 89 points, p = 0.012). After propensity score matching, the between-group differences were still significant but smaller: overall QoL - 6 points, p = 0.021; QLQ-total - 5 points, p = 0.026.
Conclusion: The differences reported at isolated time points have questionable clinical relevance. Therefore, taTME and traditional abTME seem to have comparable long-term QoL and functional outcomes.
期刊介绍：
Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.
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