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Inflammatory response after transanal total mesorectal excision

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INTRODUCTION: The advantages of transanal total mesorectal excision (taTME) would be a reduction of the hernia rate and surgical trauma. The present study reports data for patients undergoing taTME and compares the post-operative immune response in taTME with those of conven-tional laparoscopic surgery (CLS) and single-port laparo-scopic surgery (SPLS).

METHODS: A comparative cohort study in patients with rectal cancer undergoing taTME. C-reactive protein (CRP) and white blood cell count (WBC) were measured pre-operatively and on post-operative days one, two, three and four.

RESULTS: A total of 40 patients were included in taTME, 20 patients in CLS and 20 in SPLS. Patients' demographics (except for clinical staging), R0 resection and post-operative complication rates were comparable. The length of abdom-inal incisio-n was significantly lower by taTME than by both SPLS and CLS (p < 0.001). Distant resection margin was shorter in the taTME group (p < 0.01), and the quality of specimen differed between groups (p < 0.01). CRP and WBC increased significantly in each group (p < 0.05), but there was no difference between the groups.

CONCLUSIONS: There is no difference in the inflammatory response in patients with rectal cancer undergoing taTME surgery compared with CLS and SPLS. We therefore conclude that the length/presence of abdominal incision does not further reduce the post-operative inflammatory stress response in minimally invasive procedures. The surgical trauma extends beyond the abdominal incision and depends on the intra-abdominal handling of the tissue.

FUNDING: none.

TRIAL REGISTRATION: ID NCT00157972, ethical approval ID H-1-2011-007, H-15000540.

OriginalsprogEngelsk
TitelInflammatory response after transanal total mesorectal excision
Antal sider5
Vol/bind66
ForlagDanish Medical Journal
Publikationsdatojul. 2019
Udgave7
Sider1-5
StatusUdgivet - jul. 2019

ID: 58140474