ArticleSurgical endoscopy2021
The learning curve of TaTME for mid-low rectal cancer: a comprehensive analysis from a five-year institutional experience.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The learning curve of laparoscopic, robot-assisted and transanal total mesorectal excisions: a systematic review.Surgical endoscopy · 2022Pooled it
- UEG and EAES rapid guideline: Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer.Surgical endoscopy · 2022Guideline
- Long-term oncologic outcomes after transanal total mesorectal excision: a single-center cohort with a minimum of 5-year follow-up.Surgical endoscopy · 2026Article
- Surgical and oncologic outcomes of cT4b rectal cancer: a propensity score-matched comparison between a university center and regional hospitals.Annals of coloproctology · 2026Article
- The Learning Curve for Robotic Lateral Pelvic Lymph Node Dissection for Rectal Cancer: A View From the West.Diseases of the colon and rectum · 2024Observational
- Dissection layer selection based on an understanding of pelvic fascial anatomy in transanal total mesorectal excision.Annals of coloproctology · 2024Review
- Conversion rate to open surgery during transanal total mesorectal excision (TaTME) for rectal cancer: a single-center experience.Updates in surgery · 2024Article
- Article
- Prospective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine model.BMC surgery · 2024Article
- Oncological outcomes after transanal total mesorectal excision for rectal cancer.The British journal of surgery · 2023Article
- Functional outcomes after transanal total mesorectal excision (TaTME): a random forest analysis to predict patients' outcomes.Techniques in coloproctology · 2023Article
- Standardization of rectal cancer surgery and bowel preparation in Austria : A multicenter nationwide survey by the Austrian Society of Surgical Oncology.Wiener klinische Wochenschrift · 2023Article
- '4-Check' protocol for intraoperative anastomotic assessment during transanal total mesorectal excision: retrospective cohort study.BJS open · 2023Article
- Single-center comparative study of short-term outcomes of transanal and laparoscopic total mesorectal excisions for low and middle rectal cancers.Surgical endoscopy · 2023Article
- Impact of the approach on conversion to open surgery during minimally invasive restorative total mesorectal excision for rectal cancer.International journal of colorectal disease · 2023Article
- Learning curve of robotic rectal surgery using risk-adjusted cumulative summation: a 5-year institutional experience.Langenbeck's archives of surgery · 2023Article
- Article
- Modified serial techniques "ASTRO" facilitated laparoscopic total mesorectal excision for ultralow-lying rectal cancer in obese male patients: how we do it (with video).Langenbeck's archives of surgery · 2023Article
- A multidimensional learning curve analysis of totally laparoscopic ileostomy reversal using a single surgeon' s experience.Frontiers in surgery · 2023Article
- Challenges and Learning Curves in Adopting TaTME and Robotic Surgery for Rectal Cancer: A Cusum Analysis.Cancers · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTransanal total mesorectal excision (TaTME) was introduced in 2009 as a dedicated approach for the treatment of mid-low rectal cancer. We aimed to describe and discuss the learning curve for 121 consecutive TaTME procedures performed by the same team.
methodsThe primary outcome was the number of operations required to decrease the mean operative time (mOT). The secondary outcomes were the number of operations required to decrease the major complication (MC) rate, the anastomotic leakage (AL) rate, the clinical anastomotic failure rate, and the reoperation rate. A cumulative sum (CUSUM) curve analysis was used to identify the inflection points. As an integrative analysis, Bernoulli CUSUM curves, risk-adjusted CUSUM curves based on the observed-expected outcomes, and CUSUM curves targeting results reported in the literature were created.
resultsSeventy-one cases were needed to overcome the OT learning curve sufficiently to reach mastery. The MC and reoperation rates started to decrease after the 54th case and further decreased after the 69th case. The AL rate started to decrease after the 27th case and remained stable at 5-5.1%. The comparison between the different phases of the learning curves confirmed these turning points.
conclusionsTaTME had a learning curve of 71 cases for the mOT, 55-69 cases for MCs and reoperation, and 27 cases for AL. According to our results, attention should be paid during the first part of the learning curve to avoid an increased rate of MCs and AL.
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