ArticleAnnals of coloproctology2024
The impact of short-course total neoadjuvant therapy, long-course chemoradiotherapy, and upfront surgery on the technical difficulty of total mesorectal excision: an observational study with an intraoperative perspective.
Article in Annals of coloproctology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Short-term outcomes of single-port versus multi-port robotic surgery for colorectal cancer: a propensity score-matched analysis.Surgical endoscopy · 2026Article
- Prognostic significance of integrating pretreatment biopsy-derived Immunoscore and Pan-Immune-Inflammation value in locally advanced rectal cancer after neoadjuvant chemoradiotherapy.Clinical and translational radiation oncology · 2026Article
- Total Neoadjuvant Therapy Versus Conventional Chemoradiotherapy in Rectal Cancer: Impact on Tumor Regression Grade and the Predictive Value of CEA.Medicina (Kaunas, Lithuania) · 2026Article
- Clinical implications of radiologic criteria and prognostic factors for lateral lymph node metastasis in low rectal cancer.Annals of coloproctology · 2025Article
- Non-operative management of locally advanced rectal cancer with an emphasis on outcomes and quality of life: a narrative review.Ewha medical journal · 2025Review
- Left colic artery-preserving radical rectal cancer surgery: a literature review.Frontiers in surgery · 2025Review
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14 authors.
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Abstract
purposeTotal neoadjuvant therapy (TNT) is becoming the standard of care for locally advanced rectal cancer. However, surgery is deferred for months after completion, which may lead to fibrosis and increased surgical difficulty. The aim of this study was to assess whether TNT (TNT-RAPIDO) is associated with increased difficulty of total mesorectal excision (TME) compared with long-course chemoradiotherapy (LCRT) and upfront surgery.
methodsTwelve laparoscopic videos of low anterior resection with TME for rectal cancer were prospectively collected from January 2020 to October 2021, with 4 videos in each arm. Seven colorectal surgeons assessed the videos independently, graded the difficulty of TME using a visual analog scale and attempted to identify which category the videos belonged to.
resultsThe median age was 67 years, and 10 patients were male. The median interval to surgery from radiotherapy was 13 weeks in the LCRT group and 24 weeks in the TNT-RAPIDO group. There was no significant difference in the visual analog scale for difficulty in TME between the 3 groups (LCRT, 3.2; TNT-RAPIDO, 4.6; upfront, 4.1; P=0.12). A subgroup analysis showed similar difficulty between groups (LCRT 3.2 vs. TNT-RAPIDO 4.6, P=0.05; TNT-RAPIDO 4.6 vs. upfront 4.1, P=0.54). During video assessments, surgeons correctly identified the prior treatment modality in 42% of the cases. TNT-RAPIDO videos had the highest recognition rate (71%), significantly outperforming both LCRT (29%) and upfront surgery (25%, P=0.01).
conclusionTNT does not appear to increase the surgical difficulty of TME.
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