Feasibility and safety of transanal total mesorectal excision and traditional laparoscopic total mesorectal in middle-low rectal cancer: a Meta-analysis
Bibliographic record
Abstract
Objective To systematically evaluate the intraoperative and postoperative indicators, complications and pathological results of transanal total mesorectal excision (TaTME) and laparoscopic total mesorectal excision (LaTME) in the treatment of middle and low rectal cancer, and to analyze the feasibility and safety of TaTME. Methods The database both at home and abroad including Pubmed, EMBase, Cochrane Library, CNKI, Wanfang, VIP were searched between February 2015 and April 2019. All eligible studies associated with the treatment of middle and low rectal cancer with TaTME and LaTME were systematically analyzed. Newcastle-Ottawa Scale (NOS) and Revman 5.3 software were used to conduct Meta-analysis and sensitivity analysis of heterogeneous results. Results A total of thirteen articles including 1 096 cases met the inclusion criteria, including 515 cases in group TaTME and 581 cases in group LaTME. Compared with group LaTME, group TaTME had longer CRM distance (MD=0.95, 95%CI=0.61-1.29, P<0.001), lower CRM positive rate (OR=0.35, 95%CI=0.16-0.78, P=0.010), higher quality TME (OR=2.41, 95%CI=1.29-4.51, P=0.006), lower rate of conversion to laparotomy (OR=0.20, 95%CI=0.07-0.58, P=0.003), Clavien-Dindo grade≥3 complications (OR=0.54, 95%CI=0.32-0.92, P=0.020), incidence of postoperative urination disorders (OR=0.54, 95%CI=0.31-0.94, P=0.030) and lower unplanned secondary admission (OR=0.44, 95%CI=0.27-0.73, P=0.001). There were no significant differences in DRM positive rate, resection distance, number of lymph node dissection, intraoperative blood loss, duration of operation, incidence of total complications, incidence of intestinal obstruction and anastomotic leakage between the two groups. Conclusion Compared with LaTME, TaTME can obtain higher specimens quality in the treatment of middle and low rectal cancer, the incidence of serious complications after operation is significantly reduced, and the operation is feasible and safe. Key words: Rectal neoplasms; Total mesorectal excision; Transanal; Laparoscopes
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.027 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.014 | 0.059 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".