Transanal total mesorectal excision combined with intersphincteric resection has similar long-term oncological outcomes to laparoscopic abdominoperineal resection in low rectal cancer:a propensity score-matched cohort study

Background Transanal total mesorectal excision(taTME)or intersphincteric resection(ISR)has recently proven to be a valid and safe surgical procedure for low rectal cancer.However,studies focusing on the combination of these two technologies are limited.This study aimed to evaluate perioperative results,long-termoncologic outcomes,and anorectal functions of patients with low rectal cancer undergoing taTME combined with ISR,by comparing with those of patients undergoing laparoscopic abdominoperineal resection(laAPR).Methods After 1:1 propensity score matching,200 patients with low rectal cancer who underwent laAPR(n=100)or taTME combined with ISR(n=100)between September 2013 and November 2019 were included.Patient demographics,clinicopathological characteristics,oncological outcomes,and anal functional results were analysed.Results Patients in the taTME-combined-with-ISR group had less intraoperative blood loss(79.6672.6 vs 107.3665.1 mL,P=0.005)and a lower rate of post-operative complications(22.0%vs 44.0%,P<0.001)than those in the laAPR group.The overall local recurrence rates were 7.0%in both groups within 3 years after surgery.The 3-year disease-free survival rates were 86.3%in the taTME-combined-with-ISR group and 75.1%in the laAPR group(P=0.056),while the 3-year overall survival rates were 96.7%and 94.2%,respectively(P=0.319).There were 39 patients(45.3%)in the taTME-combined-with-ISR group who developed major low anterior resection syndrome,whereas 61 patients(70.9%)had good post-operative anal function(Wexner incontinence score≤10).Conclusion We found similar long-term oncological outcomes for patients with low rectal cancer undergoing laAPR and those undergoing taTME combined with ISR.Patients receiving taTME combined with ISR had acceptable post-operative anorectal function.

First preclinical experience with the newly developed EDGE SP1000 single-port robotic surgical system-assisted transanal total mesorectal excision

Introduction With advances in technology,natural orifice transluminal endoscopic surgery(NOTES)has long been an ultimate clinical pursuit in minimally invasive surgery.The transanal total mesorectal excision(taTME)in rectal surgery has been considered a representative example of the adoption of the NOTES concept[1,2].The taTME procedures offer an optimized view,better exposure of the anatomical plane.

Remarks on the Regularity Criteria of Weak Solutions to the Three-dimensional Micropolar Fluid Equations

This paper is investigate the regularity criteria of weak solutions to the three-dimensional microp- olar fluid equations. Several sufficient conditions in terms of some partial derivatives of the velocity or the pressure are obtained.

Numerical Investigation of"Frog-Leap"Mechanisms of Three Particles Aligned Moving in an Inclined Channel Flow

Intrigued by our recent experimental work(H.Yamaguchi and X.D.Ni-u,J.Fluids Eng.,133(2011),041302),the present study numerically investigate theflow-structure interactions(FSI)of three rigid circular particles aligned moving in an inclined channelflow at intermediate Reynolds numbers by using a momentum-exchanged immersed boundary-lattice Boltzmann method.A"frog-leap"phenomenon observed in the experiment is successfully captured by the present simulation and flow characteristics and underlying FSI mechanisms of it are explored by examining the ef-fects of the channel inclined angles and Reynolds numbers.It is found that the asym-metric difference of the vorticity distributions on the particle surface is the main cause of the"frog-leap"when particle moves in the boundary layer near the lower channel boundary.