Evidence map›Paper›PMID 40528078›Full record

ArticleSurgical endoscopy2025

Impact of sex differences on risk factors for postoperative complications in transanal endoscopic surgery for rectal cancer: a large-scale Japanese multicenter cohort study.

Toru Miyake, Takeru Matsuda, Ichiro Takemasa, Masatsune Shibutani, Hirokazu Suwa, Shiro Terai, Masaji Tani, Yoshihiro Kakeji, Seiichiro Yamamoto, Takeshi Naitoh and 1 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Toru MiyakeDepartment of Surgery, Shiga University of Medical Science, Shiga, Japan.
Takeru MatsudaDivision of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, -5-2 Kusunoki-Chou, Chuo-Ku, Kobe, 650-0017, Japan. takerumatsuda@nifty.com.ORCID http://orcid.org/0000-0002-9541-856X
Ichiro TakemasaDepartment of Gastroenterological Surgery, Osaka International Medical and Science Center, Osaka, Japan.
Masatsune ShibutaniDepartment of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Hirokazu SuwaDepartment of Surgery, Yokosuka Kyousai Hospital, Yokosuka, Japan.
Shiro TeraiDepartment of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Masaji TaniDepartment of Surgery, Shiga University of Medical Science, Shiga, Japan.
Yoshihiro KakejiDivision of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, -5-2 Kusunoki-Chou, Chuo-Ku, Kobe, 650-0017, Japan.
Seiichiro YamamotoDepartment of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Japan.
Takeshi NaitohDepartment of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Ta Ta Mi Study Group Collaborators from the Japan Society of Laparoscopic Colorectal Surgery

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransanal total mesorectal excision (TaTME) is a novel, minimally invasive surgery for the treatment of rectal cancer. Sex-based anatomical differences such as pelvic morphology may influence surgical difficulty and outcomes. This study aimed to investigate the correlation between sex differences and postoperative complications for patients who have undergone TaTME.

methodsThis retrospective cohort study was conducted across 26 Japan Society of Laparoscopic Colorectal Surgery centers and included 702 patients who underwent TaTME for the treatment of primary rectal cancer between January 2012 and December 2019. Patients who underwent pelvic exenteration, had recurrent or multiple cancers, or ulcerative colitis were excluded. The primary end point of this study was major postoperative complications (Clavien-Dindo [CD] grade III or higher) within 30 days of surgery. Patient characteristics, operative details, and short-term outcomes were analyzed.

resultsThis study included 484 men (68.9%) and 218 women (31.1%), of whom 310 (44.2%) underwent preoperative therapy. A total of 88 patients (12.5%) had CD grade III or higher complications, with a higher incidence in men (14.7%) than women (7.8%) (P = 0.010). In 532 patients with lower rectal tumors located within 5 cm from the anal verge, male sex remained associated with a higher rate of postoperative complications (40.8 vs. 25.4%, P = 0.001). Multivariate analysis identified the following as independent risk factors for major complications: male sex (hazard ratio [HR] = 2.13, 95% confidence interval [CI] 1.200-3.800, P = 0.010), circumferential tumor (HR = 1.82, 95% CI 1.130-2.950, P = 0.014), operative time > 479 min (HR = 1.64, 95% CI 1.010-2.670, P = 0.046), and intraoperative complications during TaTME (HR = 2.17, 95% CI 1.010-4.670, P = 0.048).

conclusionsMale sex was a significant risk factor for postoperative complications in TaTME for rectal cancer.

Indexed as

Postoperative ComplicationsRectal NeoplasmsTransanal Endoscopic SurgeryAdultAgedAged, 80 and overEast Asian PeopleFemaleHumansJapanMaleMiddle AgedRetrospective StudiesRisk FactorsSex FactorsRectal cancerSex differencesTransanal total mesorectal excision

Identifiers

PMID40528078

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.