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Tech Coloproctol. 2016 Jan;20(1):41-9. doi: 10.1007/s10151-015-1390-6. Epub 2015 Nov 11.

Midterm functional results of taTME with neuromapping for low rectal cancer.

Author information

1
Department of General, Visceral and Transplant Surgery, University Medical Center, University Medicine of the Johannes Gutenberg-University Mainz, Langenbeckstra├če 1, 55131, Mainz, Germany. W.Kneist@t-online.de.
2
Department of General, Visceral and Transplant Surgery, University Medical Center, University Medicine of the Johannes Gutenberg-University Mainz, Langenbeckstra├če 1, 55131, Mainz, Germany.
3
Department of General, Visceral and Thoracic Surgery, Leverkusen General Hospital, Leverkusen, Germany.

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.

KEYWORDS:

Function; Quality of life; Rectal cancer; TAMIS; Total mesorectal excision; Transanal; taTME

PMID:
26561031
DOI:
10.1007/s10151-015-1390-6
[Indexed for MEDLINE]

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