Scholarlink

Background <p>Transanal total mesorectal excision (TaTME) is a novel, minimally invasive surgery for the treatment of rectal cancer. Sex-based anatomical differences such as pelvic morphology may influence surgical difficulty and outcomes. This study aimed to investigate the correlation between sex differences and postoperative complications for patients who have undergone TaTME.</p> Methods <p>This retrospective cohort study was conducted across 26 Japan Society of Laparoscopic Colorectal Surgery centers and included 702 patients who underwent TaTME for the treatment of primary rectal cancer between January 2012 and December 2019. Patients who underwent pelvic exenteration, had recurrent or multiple cancers, or ulcerative colitis were excluded. The primary end point of this study was major postoperative complications (Clavien-Dindo [CD] grade III or higher) within 30&#xa0;days of surgery. Patient characteristics, operative details, and short-term outcomes were analyzed.</p> Results <p>This study included 484 men (68.9%) and 218 women (31.1%), of whom 310 (44.2%) underwent preoperative therapy. A total of 88 patients (12.5%) had CD grade III or higher complications, with a higher incidence in men (14.7%) than women (7.8%) (<i>P</i> = 0.010). In 532 patients with lower rectal tumors located within 5&#xa0;cm from the anal verge, male sex remained associated with a higher rate of postoperative complications (40.8 vs. 25.4%, <i>P</i> = 0.001). Multivariate analysis identified the following as independent risk factors for major complications: male sex (hazard ratio [HR] = 2.13, 95% confidence interval [CI] 1.200–3.800, <i>P</i> = 0.010), circumferential tumor (HR = 1.82, 95% CI 1.130–2.950, <i>P</i> = 0.014), operative time &gt; 479&#xa0;min (HR = 1.64, 95% CI 1.010–2.670, <i>P</i> = 0.046), and intraoperative complications during TaTME (HR = 2.17, 95% CI 1.010–4.670, <i>P</i> = 0.048).</p> Conclusions <p>Male sex was a significant risk factor for postoperative complications in TaTME for rectal cancer.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of sex differences on risk factors for postoperative complications in transanal endoscopic surgery for rectal cancer: a large-scale Japanese multicenter cohort study

  • 期刊论文

  • 发表日期：

    2025年6月17日

查看全文
  • Toru Miyake,
  • Takeru Matsuda,
  • Ichiro Takemasa,
  • Masatsune Shibutani,
  • Hirokazu Suwa,
  • Shiro Terai,
  • Masaji Tani,
  • Yoshihiro Kakeji,
  • Seiichiro Yamamoto,
  • Takeshi Naitoh,
  • Akihiro Kondo,
  • Akinobu Taketomi,
  • Akiyoshi Kanazawa,
  • Atsushi Ogura,
  • Chikayoshi Tani,
  • Gunpei Yoshimatsu,
  • Hideki Endo,
  • Hideya Kashihara,
  • Junichiro Kawamura,
  • Kay Uehara,
  • Kei Kimura,
  • Keiichi Okano,
  • Keiichiro Okuyama,
  • Keitaro Tanaka,
  • Kenji Okita,
  • Kiyoshi Maeda,
  • Kohei Shigeta,
  • Koji Okabayashi,
  • Koya Hida,
  • Masafumi Inomata,
  • Masahiko Watanabe,
  • Masaji Tani,
  • Masataka Ikeda,
  • Masayoshi Iwamoto,
  • Masayuki Ishii,
  • Shigenori Honma,
  • Nobuki Ichikawa,
  • Suguru Hasegawa,
  • Takeshi Okabayashi,
  • Tatsunari Fukuoka,
  • Takuya Tokunaga,
  • Tatsuya Shonaka,
  • Tatsuya Manabe,
  • Toshiki Mukai,
  • Shinichiro Mori,
  • Toshikatsu Nitta,
  • Tomonori Akagi,
  • Toru Kuramoto,
  • Yoshihito Ide,
  • Yosuke Fukunaga,
  • Yuki Murata,
  • Yukinari Tokoro,
  • Yukitoshi Todate,
  • Yusaku Shogen

摘要

Background

Transanal total mesorectal excision (TaTME) is a novel, minimally invasive surgery for the treatment of rectal cancer. Sex-based anatomical differences such as pelvic morphology may influence surgical difficulty and outcomes. This study aimed to investigate the correlation between sex differences and postoperative complications for patients who have undergone TaTME.

Methods

This retrospective cohort study was conducted across 26 Japan Society of Laparoscopic Colorectal Surgery centers and included 702 patients who underwent TaTME for the treatment of primary rectal cancer between January 2012 and December 2019. Patients who underwent pelvic exenteration, had recurrent or multiple cancers, or ulcerative colitis were excluded. The primary end point of this study was major postoperative complications (Clavien-Dindo [CD] grade III or higher) within 30 days of surgery. Patient characteristics, operative details, and short-term outcomes were analyzed.

Results

This study included 484 men (68.9%) and 218 women (31.1%), of whom 310 (44.2%) underwent preoperative therapy. A total of 88 patients (12.5%) had CD grade III or higher complications, with a higher incidence in men (14.7%) than women (7.8%) (P = 0.010). In 532 patients with lower rectal tumors located within 5 cm from the anal verge, male sex remained associated with a higher rate of postoperative complications (40.8 vs. 25.4%, P = 0.001). Multivariate analysis identified the following as independent risk factors for major complications: male sex (hazard ratio [HR] = 2.13, 95% confidence interval [CI] 1.200–3.800, P = 0.010), circumferential tumor (HR = 1.82, 95% CI 1.130–2.950, P = 0.014), operative time > 479 min (HR = 1.64, 95% CI 1.010–2.670, P = 0.046), and intraoperative complications during TaTME (HR = 2.17, 95% CI 1.010–4.670, P = 0.048).

Conclusions

Male sex was a significant risk factor for postoperative complications in TaTME for rectal cancer.