Low Anterior Resection Syndrome After Transanal Total Mesorectal Excision: A Comparison With the Conventional...

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Gastroenterology

Background:

• Sphincter-saving procedures enhance quality of life for rectal cancer patients.
• Postoperative functional disturbances, such as low anterior resection syndrome (LARS), remain a concern.
• LARS significantly impacts patient well-being after rectal cancer surgery.

Purpose of the Study:

• To evaluate the severity of LARS following transanal total mesorectal excision (TaTME).
• To compare LARS outcomes between TaTME and conventional transabdominal, top-to-bottom, total mesorectal excision (TME).

Main Methods:

• Single-center, retrospective analysis of patients with mid to low rectal cancer.
• Matched one-to-one analysis based on tumor height and pelvic irradiation history.
• Primary outcome: LARS and fecal incontinence severity at 3, 6, and 12 months post-surgery or stoma reversal.

Main Results:

• At 3 months, TaTME group had a significantly higher median LARS score (37) vs. conventional TME (32, p=0.045).
• LARS scores, severity grading, and Wexner scores were comparable between groups at 6 and 12 months.
• No significant long-term differences in anal and bowel functional outcomes were observed.

Conclusions:

• TaTME may lead to a transient increase in LARS severity in the early postoperative period.
• Both TaTME and conventional TME demonstrate similar long-term functional outcomes.
• Limitations include small sample size and retrospective design, necessitating further investigation.