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- Transanal Endoscopic Microsurgery for Patients With Rectal Tumors: A Single Institution's Experience
- Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius
- Ann Coloproctol. 2017;33(1):23-27. Published online February 28, 2017
- DOI: https://doi.org/10.3393/ac.2017.33.1.23
- 6,274 View
- 54 Download
- 12 Web of Science
- 15 Citations
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Abstract
PDF Purpose The purpose of this study was to look at our complication rates and recurrence rates, as well as the need for further radical surgery, in treating patients with benign and early malignant rectal tumors by using transanal endoscopic microsurgery (TEM).
Methods Our study included 130 patients who had undergone TEM for rectal adenomas and early rectal cancer from December 2009 to December 2015 at the Department of Surgical Oncology, National Cancer Institute, Lithuania. Patients underwent digital and endoscopic evaluation with multiple biopsies. For preoperative staging, pelvic magnetic resonance imaging or endorectal ultrasound was performed. We recorded the demographics, operative details, final pathologies, postoperative lengths of hospital stay, postoperative complications, and recurrences.
Results The average tumor size was 2.8 ± 1.5 cm (range, 0.5–8.3 cm). 102 benign (78.5%) and 28 malignant tumors (21.5%) were removed. Of the latter, 23 (82.1%) were pT1 cancers and 5 (17.9%) pT2 cancers. Of the 5 patients with pT2 cancer, 2 underwent adjuvant chemoradiotherapy, 1 underwent an abdominoperineal resection, 1 refused further treatment and 1 was lost to follow up. No intraoperative complications occurred. In 7 patients (5.4%), postoperative complications were observed: urinary retention (4 patients, 3.1%), postoperative hemorrhage (2 patients, 1.5%), and wound dehiscence (1 patient, 0.8%). All complications were treated conservatively. The mean postoperative hospital stay was 2.3 days.
Conclusion TEM in our experience demonstrated low complication and recurrence rates. This technique is recommended for treating patients with a rectal adenoma and early rectal cancer and has good prognosis.
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Citations
Citations to this article as recorded by
- TEMPOUR: A Randomized Controlled Trial Assessing Perioperative Use of an Alpha-1 Blocker to Reduce Postoperative Urinary Retention After Transanal Endoscopic Microsurgery Procedures
Thomas Couture, Claudya Morin, Janyssa Charbonneau, Émilie Papillon-Dion, Alexandre Bouchard, François Rouleau-Fournier, Philippe Bouchard, François Letarte, Alexis F. Turgeon, Sebastien Drolet
Diseases of the Colon & Rectum.2025; 68(4): 475. CrossRef - The Outcome of Local Excision of Rectal Adenomas with High-Grade Dysplasia by Transanal Endoscopic Microsurgery: A Single-Center Experience
Muhammad Khalifa, Rachel Gingold-Belfer, Nidal Issa
Journal of Clinical Medicine.2024; 13(5): 1419. CrossRef - Transanal endoscopic rectal resection: immediate and long-term results
A.A. Maslov, Yu.A. Gevorkyan, N.V. Soldatkina, A.V. Dashkov, S.I. Poluektov, V.E. Kolesnikov, D.O. Kaymakchi, A.V. Snezhko
Khirurgiya. Zhurnal im. N.I. Pirogova.2022; (1): 30. CrossRef - Complex Procedures in Transanal Endoscopic Microsurgery: Intraperitoneal Entry, Ultra Large Rectal Tumors, High Lesions, and Resection in the Anal Canal
Xavier Serra-Aracil, Victoria Lucas-Guerrero, Laura Mora-López
Clinics in Colon and Rectal Surgery.2022; 35(02): 129. CrossRef - Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef - Is Local Resection of Anal Canal Tumors Feasible with Transanal Endoscopic Surgery?
Xavier Serra‐Aracil, Andrea Campos‐Serra, Laura Mora‐López, Sheila Serra‐Pla, Anna Pallisera‐Lloveras, Roser Flores‐Clotet, Alba Zárate‐Pinedo, Salvador Navarro‐Soto
World Journal of Surgery.2020; 44(3): 939. CrossRef - Transanal endoscopic microsurgery for a rectal polyp – a video vignette
N. E. Samalavicius, P. Kavaliauskas, A. Dulskas
Colorectal Disease.2020; 22(9): 1203. CrossRef - Endoscopic diagnosis of gastrointestinal melanoma
Sheng Wang, Siyu Sun, Xiang Liu, Nan Ge, Guoxin Wang, Jintao Guo, Wen Liu, Jinlong Hu
Scandinavian Journal of Gastroenterology.2020; 55(3): 330. CrossRef - Is Previous Transanal Endoscopic Microsurgery for Early Rectal Cancer a Risk Factor of Worse Outcome following Salvage Surgery A Case-Matched Analysis
Audrius Dulskas, Aivaras Atkociunas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius
Visceral Medicine.2019; 35(3): 151. CrossRef - Transanal endoscopic microsurgery for rectal lesions in a specialist regional early rectal cancer centre: the Mersey experience
M. Ondhia, P. Tamvakeras, P. O'Toole, A. Montazerri, T. Andrews, C. Farrell, S. Ahmed, S. Slawik, S. Ahmed
Colorectal Disease.2019; 21(10): 1164. CrossRef - Transanal Endoscopic Microsurgery for Patients with Rare Rectal Tumors
Xin Wu, Guole Lin, Huizhong Qiu, Jiaolin Zhou
Journal of Laparoendoscopic & Advanced Surgical Techniques.2018; 28(5): 546. CrossRef - Modern management of T1 rectal cancer by transanal endoscopic microsurgery: a 10‐year single‐centre experience
H. J. S. Jones, R. Hompes, N. Mortensen, C. Cunningham
Colorectal Disease.2018; 20(7): 586. CrossRef - Transanal endoscopic microsurgery as day surgery – a single‐centre experience with 500 patients
C. J. Brown, J. Q. Gentles, T. P. Phang, A. A. Karimuddin, M. J. Raval
Colorectal Disease.2018;[Epub] CrossRef - Transanal Endoscopic Microsurgery
Byung Chun Kim
Annals of Coloproctology.2017; 33(1): 5. CrossRef - Transanal endoscopic microsurgery for giant benign rectal tumours: is large size a contraindication?
Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius
International Journal of Colorectal Disease.2017; 32(12): 1759. CrossRef
- TEMPOUR: A Randomized Controlled Trial Assessing Perioperative Use of an Alpha-1 Blocker to Reduce Postoperative Urinary Retention After Transanal Endoscopic Microsurgery Procedures
- Local Excision of Rectal Carcinoma.
- Shin, Dong Gyeu , Shim, Kang Sup , Kim, Kwang Ho
- J Korean Soc Coloproctol. 1999;15(1):73-81.
- 1,243 View
- 1 Download
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Abstract
PDF
- PURPOSE
Curative local excision of the rectal cancer had been advocated by many surgeons over the standard abdominoperineal resection (APR) for lower rectal cancer due to its low complication rate and improved quality of life. The aim of this study was to evaluate the result of the local excision for rectal cancer.
METHOD
We prospectively analyzed 31 rectal cancer patients (including 2 patients of carcinoid tumor) who were suitable indication for local excision between Oct. 1993 and Dec. 1998 at Mokdong Hospital.
RESULTS
The age of the patients ranged from 39 to 81 years (>60 years: 77.8%) while sex ratio was 1:5 (M:F). Of 31 patients, 29 patients were located below 4 cm from anal verge. Other two were in between 7 cm and 10 cm from the anal verge. The tumor size ranged from 0.7 cm to 5 cm, most commonly within 3 cm. Invasion depth by tumor were as follows: 12 patients in mucosa; 7 patients in submucosa; 4 patients in inner muscle layer; 6 patients in outer muscle layer; and 2 patients in whole layer. Ten patients had well-differentiated tumors and 17 patients had moderately differentiated tumors, while one patient had mucinous histologic type. Seventy percent of patients with muscular layer invasion received adjuvant radiation therapy. Six patients received oral chemotherapeutic agent and 4 received immunopotentiator. During the follow-up period (mean: 18.4 months, range: 1~54 months), no local recurrence was found in the patients who were operated under curative intent.
CONCLUSION
We concluded that this method can be favorabe choice for the treatment of early rectal cancer without lymph node involvement if strict indication of the local excision for rectal cancer could be applied.
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