title: Midterm functional results of taTME with neuromapping for low rectal cancer.
abstract: BACKGROUND
  Information on functional outcomes after laparoscopic-assisted transanal total mesorectal excision (taTME) is limited. This study analyzed the functional results in patients with low rectal cancer.
  
  
  METHODS
  Ten consecutive patients (nine males) undergoing electrophysiologically controlled nerve-sparing taTME were investigated prospectively and asked to complete functional questionnaires [the International Prostate Symptom Score (IPSS), International Index of Erectile Function, Female Sexual Function Index, Wexner score, and low anterior resection syndrome (LARS) score]. Bladder function was also assessed according to residual urine volume. Preoperative function was compared to the functional outcome 3 and 6 months, and 9 months if eligible, after stoma closure or surgery in the absence of a diverting stoma.
  
  
  RESULTS
  Prior to therapy, urinary and sexual function was impaired in 40 and 60% of patients, respectively. None of the patients developed pathological residual urine volumes after at least unilateral functional pelvic nerve-sparing. Median IPSS was lower than preoperative scores (p > 0.05). Two males with incomplete nerve preservation were considered impotent during a median follow-up of 15 months (range 6-20 months). The female was judged to be sexually inactive. The median Wexner score was 1 (range 0-7) prior to any therapy and increased to 7 (range 0-15) at 6 months (p = 0.029), with 40% of patients categorized as having no LARS and 50% minor LARS. The median LARS score was 28 (range 9-38) at 3 months and 26 (range 9-32) at 6 months (p = 0.165).
  
  
  CONCLUSIONS
  Despite a small sample size and confounding factors, data indicate that taTME has the potential to preserve continence, sufficient bowel function, and urogenital function.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Medical Center, University Medicine of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany. W.Kneist@t-online.de.
authors.forename: W
authors.initials: W
authors.lastname: Kneist
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Medical Center, University Medicine of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Wachter
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Medical Center, University Medicine of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Paschold
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Medical Center, University Medicine of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
authors.forename: D W
authors.initials: DW
authors.lastname: Kauff
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Medical Center, University Medicine of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.|Department of General, Visceral and Thoracic Surgery, Leverkusen General Hospital, Leverkusen, Germany.
authors.forename: A D
authors.initials: AD
authors.lastname: Rink
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Medical Center, University Medicine of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Lang
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D059351:Organ Sparing Treatments / Q000379:methods; D010388:Pelvis / Q000294:innervation / Q000601:surgery; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000294:innervation / Q000601:surgery; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011795:Surveys and Questionnaires; D000067368:Transanal Endoscopic Surgery / Q000379:methods*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000502:physiology; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery
keywords: Function; Quality of life; Rectal cancer; TAMIS; Total mesorectal excision; Transanal; taTME