055. The Comparative Efficacy Surgical Techniques of Transanal Endoscopic Microsurgery Versus Radical Resection for Early-Stage Rectal Cancer: A Systematic Review And Meta-Analysis

Background: Colorectal cancer ranks third in incidence and second in mortality among all tumours. Radical surgery has been the conventional treatment for early-stage rectal cancer. Advancements in medical technology have established Transanal Endoscopic Microsurgery (TEM.) as a viable minimally inva...

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Main Authors: Ni Putu Ruspata Bhyantari, I Made Mulyawan
Format: Article
Language:English
Published: Universitas Udayana 2024-11-01
Series:JBN (Jurnal Bedah Nasional)
Online Access:https://ojs.unud.ac.id/index.php/jbn/article/view/119999
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author Ni Putu Ruspata Bhyantari
I Made Mulyawan
author_facet Ni Putu Ruspata Bhyantari
I Made Mulyawan
author_sort Ni Putu Ruspata Bhyantari
collection DOAJ
description Background: Colorectal cancer ranks third in incidence and second in mortality among all tumours. Radical surgery has been the conventional treatment for early-stage rectal cancer. Advancements in medical technology have established Transanal Endoscopic Microsurgery (TEM.) as a viable minimally invasive surgical treatment for early-stage cancer. Nonetheless, there is still ambiguity regarding the selection of surgical methods for individuals with early-stage rectal carcinoma. This meta-analysis aims to compare the outcomes of two surgical techniques. Methods: We searched PubMed, Web of Science, and the Cochrane Library to discover research and trials published from 2010 up to 2023. We utilised Revman 5.4.2 to do the meta-analysis. Results: Five studies were considered, comprising 358 patients, including transanal endoscopic microsurgery and radical resection for early-stage rectal cancer. Our findings indicate that TEM surgical approach was significant in reducing intraoperative bleeding MD -131.18 95% CI [-205.79;-56.56] p=0.0006, operative time MD -82.37 95% CI [-97.59;-67,16] p< 0.00001. However, our result shows that TEM surgical increased hospital stay MD -2.50 95% CI [-10.94;-5.95] p< 0.56. We also found TEM surgery was associated with lowering the incidence of post-operative bleeding RR 0.32 95% CI [0.11,0.97] p =0.04 and permanent stoma RR 0.25 95% CI [0.07,0.83] p =0.02. Conclusion: This study demonstrated that TEM surgery was associated with reducing the incidence of intra-operative bleeding, operative time, post-operative bleeding and permanent stoma. Additional investigations are required to validate these findings.
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spelling doaj-art-8a31aea876a7499cbd0b5bbc5ac12a722025-08-20T02:14:42ZengUniversitas UdayanaJBN (Jurnal Bedah Nasional)2548-59622548-981X2024-11-0182S55S5510.24843/JBN.2024.v08.is02.p055119999055. The Comparative Efficacy Surgical Techniques of Transanal Endoscopic Microsurgery Versus Radical Resection for Early-Stage Rectal Cancer: A Systematic Review And Meta-AnalysisNi Putu Ruspata Bhyantari0I Made Mulyawan1General Surgery Resident, Medical Faculty of Udayana University, Prof I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, IndonesiaDigestive Surgery Division, Department of Surgery, Medical Faculty of Udayana University, Prof I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, IndonesiaBackground: Colorectal cancer ranks third in incidence and second in mortality among all tumours. Radical surgery has been the conventional treatment for early-stage rectal cancer. Advancements in medical technology have established Transanal Endoscopic Microsurgery (TEM.) as a viable minimally invasive surgical treatment for early-stage cancer. Nonetheless, there is still ambiguity regarding the selection of surgical methods for individuals with early-stage rectal carcinoma. This meta-analysis aims to compare the outcomes of two surgical techniques. Methods: We searched PubMed, Web of Science, and the Cochrane Library to discover research and trials published from 2010 up to 2023. We utilised Revman 5.4.2 to do the meta-analysis. Results: Five studies were considered, comprising 358 patients, including transanal endoscopic microsurgery and radical resection for early-stage rectal cancer. Our findings indicate that TEM surgical approach was significant in reducing intraoperative bleeding MD -131.18 95% CI [-205.79;-56.56] p=0.0006, operative time MD -82.37 95% CI [-97.59;-67,16] p< 0.00001. However, our result shows that TEM surgical increased hospital stay MD -2.50 95% CI [-10.94;-5.95] p< 0.56. We also found TEM surgery was associated with lowering the incidence of post-operative bleeding RR 0.32 95% CI [0.11,0.97] p =0.04 and permanent stoma RR 0.25 95% CI [0.07,0.83] p =0.02. Conclusion: This study demonstrated that TEM surgery was associated with reducing the incidence of intra-operative bleeding, operative time, post-operative bleeding and permanent stoma. Additional investigations are required to validate these findings.https://ojs.unud.ac.id/index.php/jbn/article/view/119999
spellingShingle Ni Putu Ruspata Bhyantari
I Made Mulyawan
055. The Comparative Efficacy Surgical Techniques of Transanal Endoscopic Microsurgery Versus Radical Resection for Early-Stage Rectal Cancer: A Systematic Review And Meta-Analysis
JBN (Jurnal Bedah Nasional)
title 055. The Comparative Efficacy Surgical Techniques of Transanal Endoscopic Microsurgery Versus Radical Resection for Early-Stage Rectal Cancer: A Systematic Review And Meta-Analysis
title_full 055. The Comparative Efficacy Surgical Techniques of Transanal Endoscopic Microsurgery Versus Radical Resection for Early-Stage Rectal Cancer: A Systematic Review And Meta-Analysis
title_fullStr 055. The Comparative Efficacy Surgical Techniques of Transanal Endoscopic Microsurgery Versus Radical Resection for Early-Stage Rectal Cancer: A Systematic Review And Meta-Analysis
title_full_unstemmed 055. The Comparative Efficacy Surgical Techniques of Transanal Endoscopic Microsurgery Versus Radical Resection for Early-Stage Rectal Cancer: A Systematic Review And Meta-Analysis
title_short 055. The Comparative Efficacy Surgical Techniques of Transanal Endoscopic Microsurgery Versus Radical Resection for Early-Stage Rectal Cancer: A Systematic Review And Meta-Analysis
title_sort 055 the comparative efficacy surgical techniques of transanal endoscopic microsurgery versus radical resection for early stage rectal cancer a systematic review and meta analysis
url https://ojs.unud.ac.id/index.php/jbn/article/view/119999
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