Evidence map›Paper›PMID 30911795›Full record

ReviewDer Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen2019

[Transanal total mesorectal excision-a critical appraisal].

C Holmer, S Benz, S Fichtner-Feigl, E C Jehle, P Kienle, S Post, T Schiedeck, J Weitz, M E Kreis

Abstract readReview
PubMed Publisher
In one paragraph

Review in Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. [Transanal total mesorectal excision-Indications, technique and results].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2020
    Review
  3. [TaTME is an experimental procedure].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 1 country.

C HolmerCharité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Hindenburgdamm 30, 12200, Berlin, Deutschland.
S BenzKlinikum Sindelfingen-Böblingen, Klinik für Allgemein‑, Viszeral- und Kinderchirurgie, Klinikverbund Südwest, Böblingen, Deutschland.
S Fichtner-FeiglKlinik für Allgemein- und Viszeralchirurgie, Department Chirurgie, Universitätsklinikum Freiburg, Freiburg, Deutschland.
E C JehleKlinik für Allgemein- und Viszeralchirurgie, St. Elisabethen-Klinikum, Ravensburg, Deutschland.
P KienleKlinik für Allgemein- und Viszeralchirurgie, Theresienkrankenhaus, Mannheim, Deutschland.
S PostChirurgische Klinik, Universitätsklinikum Mannheim, Mannheim, Deutschland.
T SchiedeckKlinik für Allgemein- und Viszeralchirurgie, Klinikum Ludwigsburg, Ludwigsburg, Deutschland.
J WeitzKlinik und Poliklinik für Viszeral‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Deutschland.
M E KreisCharité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Hindenburgdamm 30, 12200, Berlin, Deutschland. martin.kreis@charite.de.
Charité - Universitätsmedizin Berlin · DEDiabetesinstitut Heidelberg · DEKlinikum Ludwigsburg · DEKlinik und Poliklinik für Psychotherapie und Psychosomatik · DEKlinikverbund Südwest · DEUniversity Hospital Heidelberg · DEUniversity Medical Center Freiburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTotal mesorectal excision (TME) is the international standard for rectal cancer surgery. In addition to laparoscopic TME (lapTME), transanal TME (taTME) was developed in recent years to reduce the rate of incomplete TME, conversion to open surgery and postoperative functional impairment. Despite limited evidence, this technique is becoming increasingly more popular and is already routinely used by many hospitals for rectal cancer in varying tumor level locations. The aim of this review was to evaluate the taTME compared to anterior rectal resection with lapTME as the standard of care in rectal cancer surgery based on currently available evidence.

methodThe databases PubMed and Medline were systematically searched for publications on transanal total mesorectal excision (taTME) and transanal minimally invasive surgery (TAMIS). Relevant studies were selected and further research based on the reference lists was undertaken.

resultsA total of 16 studies analyzing 3782 patients were identified. The taTME does not lead to a higher rate of complete TME-resected specimens compared to the standard procedure. So far, superiority could not be demonstrated for complication rates or for functional or oncological results. Serious complications secondary to dissection in incorrect planes were observed. The anastomotic level generally seems to be closer to the sphincter after taTME versus anterior lapTME.

conclusionConsidering current evidence, taTME failed to show superiority compared to conventional anterior lapTME. Although taTME has some potential advantages, it carries substantial risks. If performed outside of clinical trials, it should therefore only be used in carefully selected patients with a high possibility of conversion, following adequate patient informed consent and after intense and systematic training of the surgeon.

Indexed as

LaparoscopyRectal NeoplasmsTransanal Endoscopic SurgeryHumansPostoperative ComplicationsRectumRectal cancerRectal resectionTransanal minimally invasive surgeryTransanal surgeryTransanal total mesorectal excision

Identifiers

PMID30911795
OpenAlexW2939916651

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.