Learning Curve for Transanal Total Mesorectal Excision for Low Rectal Malignancy

医学 全直肠系膜切除术 外科 结直肠癌 恶性肿瘤 内科学 癌症
作者
Takeru Matsuda,Sawada Ryuichiro,H. Hasegawa,Kimihiro Yamashita,Hitoshi Harada,Naoki Urakawa,Hironobu Goto,Shingo Kanaji,Taro Oshikiri,Yoshihiro Kakeji
出处
期刊:Journal of The American College of Surgeons [Lippincott Williams & Wilkins]
被引量:9
标识
DOI:10.1097/xcs.0000000000000608
摘要

Although transanal total mesorectal excision (TaTME) is a promising treatment for low rectal cancer, it is considered technically demanding, and the number of cases required to become proficient in TaTME remains unknown. The purpose of this study was to assess the TaTME learning curve based on the total mesorectal excision completion time.This retrospective analysis comprised 128 individuals who received TaTME between September 2016 and December 2021. The cumulative sum method was used to generate the learning curve. The duration of the procedure from the beginning to the end of the circumferential rendezvous was used to define the total mesorectal excision completion time.The learning curve consists of 3 phases: phase I (learning phase: cases 1 to 38), phase II (consolidation phase: cases 39 to 70), and phase III (maturing phase: cases 71 to 128). As the phases varied, both the overall operative time and total mesorectal excision completion time decreased considerably. Through the 3 phases of TaTME, intraoperative adverse events decreased, and in phase III, none occurred. Only 1 instance of local recurrence occurred during phase III, and none occurred during phase I or II.After 70 operations, the surgeon could join the mastery phase of TaTME based on the total mesorectal excision completion time. After the mastering phase began, there were no intraoperative negative occurrences. From the beginning, the oncological safety could be guaranteed.
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