Background and objectivesTransanal total mesorectal excision (TaTME) is positioned at the cutting edge of minimally invasive approach to mid- and low rectal cancer. This meta-analysis was to compare the short- and long-term outcomes of TaTME versus laparoscopic total mesorectal excision (LTME) and to evaluate the safety, efficacy, and possible superiority of TaTME.MethodsA comprehensive search was conducted for randomized controlled trials (RCTs) and non-RCTs (NRCTs) comparing TaTME with LTME. Inter-group differences were evaluated via standardized mean differences and relative risks (RRs). All outcomes were analyzed using fixed effects or random effects models according to the heterogeneity. Statistical analysis was performed using Stata/SE 12.0 software.ResultsEleven studies (1 RCT and 10 NRCTs) with involving 757 patients were included. Among which, 361 patients underwent TaTME and 396 patients underwent LTME. Comparing the surgical and oncological quality of resection of TaTME with that of LTME, reports of TaTME indicated favorable outcomes considering mesorectal resection quality, circumferential resection margin involvement, intraoperative blood loss, conversions, and postoperative complications, while the differences between the two groups had no statistical significance in terms of distal resection margin, harvested lymph node, operation time, hospital stay, recurrence, 2-year overall survival (OS), and 2-year disease-free survival.ConclusionTaTME is a promising surgical technique and is fully a safe, efficacious, and diffusible alternative to LTME in managing mid- and distal rectal cancer. Larger scale, national, multicentric RCTs are warranted to further verify these results and the possible superiority of TaTME.
第一作者机构：[1]Kunming Med Univ, Dept Colorectal Canc Surg, Clin Res Ctr Colorectal Canc, Tumor Hosp Yun Nan Prov,Affiliated Hosp 3, Kunming, Yunnan, Peoples R China
通讯作者：
推荐引用方式(GB/T 7714)：
Zhang Xuan,Gao Yi,Dai XingLong,et al.Short- and long-term outcomes of transanal versus laparoscopic total mesorectal excision for mid-to-low rectal cancer: a meta-analysis[J].SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES.2019,33(3):972-985.doi:10.1007/s00464-018-6527-z.
APA：
Zhang, Xuan,Gao, Yi,Dai, XingLong,Zhang, HongTao,Shang, ZhongJun...&Li, YunFeng.(2019).Short- and long-term outcomes of transanal versus laparoscopic total mesorectal excision for mid-to-low rectal cancer: a meta-analysis.SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES,33,(3)
MLA：
Zhang, Xuan,et al."Short- and long-term outcomes of transanal versus laparoscopic total mesorectal excision for mid-to-low rectal cancer: a meta-analysis".SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 33..3(2019):972-985
医学