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Joost A.G. van der Heijden,Kelly G.H. van de Pas,Frank J.C. van den Broek,Francois M.H. van Dielen,Gerrit D. Slooter,Adriana J.G. Maaskant-Braat 대한대장항문학회 2022 Annals of Coloproctolgy Vol.38 No.1
Purpose: Transanal total mesorectal excision (TaTME) was developed to overcome surgical difficulties experienced in distal pelvic dissection. Concerns have been raised about potential worse postoperative functional outcomes after TaTME. Also, the oncological safety was questioned. This study aimed to describe the functional, surgical, oncological outcomes and quality of life (QoL) after TaTME. Methods: All consecutive TaTME cases for rectal cancer without disseminated disease between December 2016 and April 2019 were included. The Wexner incontinence score, low anterior resection syndrome (LARS) score, fecal incontinence-related QoL, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-core questionnaire and 29-item module (EORTC QLQ-C30/CR29) were collected. Kaplan-Meier analysis was used to calculate local recurrence-free survival. Results: Thirty patients were eligible for analysis of which 23 received questionnaires. Response rate was 74%. After a median follow-up of respectively 20.0 and 23.0 months for functional and oncological outcomes, the median (interquartile range) of Wexner incontinence and LARS scores were 9.0 (7.0–12.0) and 33.1 (25.0–39.0). Major LARS was present in 73.3%. Fecal incontinence, general and colorectal-specific QoL subdomains that are associated with poor bowel function scored in line with previously reported data. The 2-year actuarial cumulative local recurrence rate was 3.7% (95% confidence interval, 2.4%–5.0%). Conclusion: TaTME may lead to significant functional impairments. Patients should receive preoperative counseling on this topic and be fully aware of the potential consequences of their treatment. Oncological data were in line with other short- to moderate-term data and did not show alarming results.
Seo, K.W.,Waliser, D.E.,Lee, C.K.,Tian, B.,Scambos, T.,Kim, B.M.,van Angelen, J.H.,van den Broeke, M.R. Elsevier 2015 Global and planetary change Vol.128 No.-
Understanding the mechanisms that drive the mass imbalance of the Greenland ice sheet (GrIS) is critical to the accurate projection of its contribution to future sea level rise. Greenland's ice mass loss has been accelerating recently. Using satellite Earth-gravity and regional climate model data, we show that the acceleration rate of Greenland ice mass loss from 2003 to 2012 is -13.9+/-2.0Gt/yr<SUP>2</SUP>, which results mainly from an increase of meltwater runoff (-6.3+/-1.1Gt/yr<SUP>2</SUP>) and a decrease of precipitation (-4.8+/-1.1Gt/yr<SUP>2</SUP>). Before the extreme surface melting in the summers of 2010 and 2012, the decrease of precipitation (-9.7+/-2.5Gt/yr<SUP>2</SUP>) was a larger contributor to the ice mass loss acceleration than the increase of runoff (-2.1+/-2.2Gt/yr<SUP>2</SUP>). Furthermore, we show that the North Atlantic Oscillation (NAO) is linked to the precipitation decrease during summer, and its recent influence to Greenland is anomalously large possibly due to the change in atmospheric circulation in the North Atlantic. These results indicate that inter-annual climate variability is playing a significant role in the recently observed Greenland ice mass loss acceleration, underscoring the difficulty of projecting future sea level rise based on the recent observations of GrIS mass loss.