{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T14:55:06Z","timestamp":1773327306036,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T00:00:00Z","timestamp":1552521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010477","name":"Intuitive Surgical","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010477","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Total mesorectal excision (<jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content>) is the standard of care for rectal cancer, which can be combined with low anterior resection (<jats:styled-content style=\"fixed-case\">LAR<\/jats:styled-content>) in patients with mid\u2010to\u2010low rectal cancer. The narrow pelvic space and difficulties in obtaining adequate exposure make surgery technically challenging. Four techniques are used to perform the surgery: open laparotomy, laparoscopy, robot\u2010assisted surgery and transanal surgery. Comparative data for these techniques are required to provide clinical data on the surgical management of rectal cancers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Rectal Surgery Evaluation Trial will be a prospective, observational, case\u2010matched, four\u2010cohort, multicentre trial designed to study <jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">LAR<\/jats:styled-content> using open laparotomy, laparoscopy, robot\u2010assisted surgery or transanal surgery in high\u2010surgical\u2010risk patients with mid\u2010to\u2010low non\u2010metastatic rectal cancer. All surgeries will be performed by surgeons experienced in at least one of the techniques. Oncological, morbidity and functional outcomes will be assessed in a composite primary outcome, with success defined as circumferential resection margin \u2265\u00a01\u00a0mm, <jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> Grade <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> and minimal postoperative morbidity (absence of Clavien\u2013Dindo Grade <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\u2013<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> complications within 30\u00a0days after surgery). Secondary end\u2010points will include the co\u2010primary end\u2010points over the long term (2\u00a0years), quality of surgery, quality of life, length of hospital stay, operative time and rate of unplanned conversions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This will be the first trial to study all four surgical techniques currently used for <jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">LAR<\/jats:styled-content> in a specific group of high\u2010risk patients. The knowledge obtained will contribute towards helping physicians determine the advantages of each technique and which may be the most appropriate for their patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14581","type":"journal-article","created":{"date-parts":[[2019,2,11]],"date-time":"2019-02-11T07:54:28Z","timestamp":1549871668000},"page":"516-522","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Rectal Surgery Evaluation Trial: protocol for a parallel cohort trial of outcomes using surgical techniques for total mesorectal excision with low anterior resection in high\u2010risk rectal cancer patients"],"prefix":"10.1111","volume":"21","author":[{"given":"P.","family":"Rouanet","sequence":"first","affiliation":[{"name":"Surgery Department Montpellier Cancer Institute (ICM) University of Montpellier Montpellier 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