Evidence map›Paper›PMID 36376924›Full record

ArticleWorld journal of surgical oncology2022

Transanal down-to-up dissection of the distal rectum as a viable approach to achieve total mesorectal excision in laparoscopic sphincter-preserving surgery for rectal cancer near the anus: a study of short- and long-term outcomes of 123 consecutive patients from a single Japanese institution.

Satoru Kagami, Kimihiko Funahashi, Takamaru Koda, Toshimitsu Ushigome, Tomoaki Kaneko, Takayuki Suzuki, Yasuyuki Miura, Yasuo Nagashima, Kimihiko Yoshida, Akiharu Kurihara

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 40% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Short-term outcomes of laparoscopic-assisted transanalWorld journal of gastrointestinal surgery · 2026
    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

10 authors at 2 institutions in 1 country.

Satoru KagamiDepartment of General and Gastroenterological Surgery, Toho University Omori Medical Center, 6-11-1 Omorinishi Ota-ku, Tokyo, 143-8541, Japan.
Kimihiko FunahashiDepartment of General and Gastroenterological Surgery, Toho University Omori Medical Center, 6-11-1 Omorinishi Ota-ku, Tokyo, 143-8541, Japan. kingkong@med.toho-u.ac.jp.
Takamaru KodaDepartment of General and Gastroenterological Surgery, Toho University Omori Medical Center, 6-11-1 Omorinishi Ota-ku, Tokyo, 143-8541, Japan.
Toshimitsu UshigomeDepartment of General and Gastroenterological Surgery, Toho University Omori Medical Center, 6-11-1 Omorinishi Ota-ku, Tokyo, 143-8541, Japan.
Tomoaki KanekoDepartment of General and Gastroenterological Surgery, Toho University Omori Medical Center, 6-11-1 Omorinishi Ota-ku, Tokyo, 143-8541, Japan.
Takayuki SuzukiDepartment of General and Gastroenterological Surgery, Toho University Omori Medical Center, 6-11-1 Omorinishi Ota-ku, Tokyo, 143-8541, Japan.
Yasuyuki MiuraDepartment of General and Gastroenterological Surgery, Toho University Omori Medical Center, 6-11-1 Omorinishi Ota-ku, Tokyo, 143-8541, Japan.
Yasuo NagashimaDepartment of General and Gastroenterological Surgery, Toho University Omori Medical Center, 6-11-1 Omorinishi Ota-ku, Tokyo, 143-8541, Japan.
Kimihiko YoshidaDepartment of General and Gastroenterological Surgery, Toho University Omori Medical Center, 6-11-1 Omorinishi Ota-ku, Tokyo, 143-8541, Japan.
Akiharu KuriharaDepartment of General and Gastroenterological Surgery, Toho University Omori Medical Center, 6-11-1 Omorinishi Ota-ku, Tokyo, 143-8541, Japan.
Toho University · JPToho University Omori Medical Center · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn rectal cancer (RC) surgery, the complexity of total mesorectal excision (TME) in laparoscopic sphincter-preserving surgery (lap-SPS) for RC near the anus has been a critical issue. Recently, technical assistance via the anus for complete TME has been receiving attention. This study aimed at clarifying the transanal down-to-up dissection viability for achieving TME in lap-SPS for RC near the anus.

methodsWe evaluated surgical and oncological outcomes of a total of 123 consecutive patients undergoing either a transanal rectal dissection (TARD) under direct vision mobilizing the most difficult portion of TME via the anus or the transanal TME by using an endoscopic system (TaTME) for achieving TME in lap-SPS for RC near the anus between January 2006 and February 2021.

resultsA total of 123 consecutive patients (83 men) with a median age of 66 years (range 33-86 years) were included. TARD and TaTME were performed for 50 (40.7%) and for 73 (59.3%) patients, respectively. Preoperative treatment was performed for 40 (32.5%) patients, resulting in a complete pathological response in 5 (12.5%) patients. Intersphincteric resection was performed significantly more in the TARD group (p<0.001). Although the TaTME group needed a longer operative time at the transanal portion (p<0.001), the median blood loss was lower (p<0.001). Postoperative complications with the Clavien-Dindo classification grade ≧2 developed in 52 (42.3%) patients. Urinary dysfunction and stoma-related complications were found most frequently. More patients needing medication for urinary dysfunction were found in the TARD group, but a significant difference was not observed (10.0% vs. 6.8%, p=0.526). The quality of TME was good for almost all patients. Recurrence developed in 18 (14.6%) patients. The 5-year overall survival (OS) and relapse-free survival (RFS) rates in 123 patients were 95.8% and 88.8%, respectively. The 5-year OS and RFS between the two groups were comparable.

conclusionsOur data suggested that a transanal down-to-up dissection of the distal rectum might be a viable approach in lap-SPS for RC near the anus. Further studies are needed to examine the differences between TARD and TaTME.

Indexed as

LaparoscopyRectal NeoplasmsTransanal Endoscopic SurgeryAdultAgedAged, 80 and overAnal CanalHumansJapanMaleMiddle AgedNeoplasm Recurrence, LocalPostoperative ComplicationsRectumTreatment OutcomeLaparoscopic sphincter preserving surgeryRectal cancer near the anusTransanal down-to-up dissection of down-to-up dissection of the distal rectumTransanal rectal dissectionTransanal total mesorectal excision

Identifiers

PMID36376924
PMCPMC9664677
OpenAlexW4309087204

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.