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Surgical Endoscopy
Published in: Surgical Endoscopy 4/2011

01-04-2011

Transanal endoscopic microsurgery for 135 patients with small nonadvanced low rectal cancer (iT1–iT2, iN0): short- and long-term results

Authors: Giovanni Lezoche, Mario Guerrieri, Maddalena Baldarelli, Alessandro Maria Paganini, Giancarlo D’Ambrosio, Roberto Campagnacci, Silvia Bartolacci, Emanuele Lezoche

Published in: Surgical Endoscopy | Issue 4/2011

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Abstract

Background

Local excision of rectal cancer as an alternative to radical resection for patients with small nonadvanced low rectal cancer (SNALRC) (iT1–iT2, iN0) is debated. This study aimed to analyze the short- and long-term results for a series of 135 patients with SNALRC who underwent local excision by transanal endoscopic microsurgery (TEM).

Methods

According to the study protocol, 135 patients classified by endorectal ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) imaging as having iT1 iN0 iM0 (n = 51) or iT2 iN0 iM0 (n = 84) low rectal cancer were enrolled in the study. All the patients with iT2 rectal cancer underwent neoadjuvant therapy. The definitive histologic findings showed 24 pT0 patients (17.8%), 66 pT1 patients (48.8%), and 45 pT2 patients (33.4%).

Results

Minor complications were observed in 12 patients (8.8%) and major complications in 2 patients (1.5%). During a median follow-up period of 97 months (range, 55–139 months), local recurrences occurred for four patients and distant metastases for two patients. The patients who experienced a recurrence had been preoperatively staged as iT2 and were low or nonresponders to neoadjuvant treatment (ypT2). At the end of the follow-up period, the disease-free survival rates were 100% for the iT1 patients and 93% for the iT2 patients

Conclusions

The long-term results for adequate local excision by TEM with or without neoadjuvant radiochemotherapy in the treatment of SNALRC based on the current study protocol are not inferior to those reported in the literature for radical surgery with total mesorectal excision (TME).
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Metadata
Title
Transanal endoscopic microsurgery for 135 patients with small nonadvanced low rectal cancer (iT1–iT2, iN0): short- and long-term results
Authors
Giovanni Lezoche
Mario Guerrieri
Maddalena Baldarelli
Alessandro Maria Paganini
Giancarlo D’Ambrosio
Roberto Campagnacci
Silvia Bartolacci
Emanuele Lezoche
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 4/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1347-9

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