Clinical outcomes of transanal total mesorectal excision using a lateral-first approach for low rectal cancer: a propens
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and Other Interventional Techniques
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Clinical outcomes of transanal total mesorectal excision using a lateral‑first approach for low rectal cancer: a propensity score matching analysis Takeru Matsuda1,2 · Kimihiro Yamashita1 · Hiroshi Hasegawa1 · Masataka Fujikawa1 · Hiroki Sakamoto1 · Masashi Yamamoto1 · Shingo Kanaji1 · Taro Oshikiri1 · Tetsu Nakamura1 · Satoshi Suzuki1 · Yoshihiro Kakeji1 Received: 6 May 2020 / Accepted: 16 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Although transanal total mesorectal excision (ta-TME) is adopted for rectal cancer surgery by an increasing number of surgeons, it is still technically challenging. We have employed a lateral-first approach for ta-TME to overcome technical difficulties. However, its outcomes and advantage over conventional laparoscopic TME remain unclear. Methods Thirty-five consecutive patients who underwent ta-TME using a lateral-first approach (the ta-TME group) and 53 consecutive patients who underwent conventional laparoscopic TME (the lap-TME group) for low rectal cancer were included. Propensity score matching (PSM) was used to create balanced cohorts of ta-TME (n = 28) and lap-TME (n = 28). Their clinical outcomes were compared after PSM. Results The operative time and intraoperative blood loss were significantly lower in the ta-TME group than in the lap-TME group (P = 0.042 and P
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