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Surgical Endoscopy
Published in: Surgical Endoscopy 4/2014

01-04-2014

Endoscopic submucosal dissection versus transanal endoscopic microsurgery for the treatment of early rectal cancer

Authors: Fábio Shiguehissa Kawaguti, Caio Sérgio Rizkallah Nahas, Carlos Frederico Sparapan Marques, Bruno da Costa Martins, Felipe Alves Retes, Raphael Salles S. Medeiros, Takemasa Hayashi, Yoshiki Wada, Marcelo Simas de Lima, Ricardo Sato Uemura, Sérgio Carlos Nahas, Shin-ei Kudo, Fauze Maluf-Filho

Published in: Surgical Endoscopy | Issue 4/2014

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Abstract

Background

Endoscopic submucosal dissection (ESD) and transanal endoscopic microsurgery (TEM) are minimally invasive procedures that can be used to treat early rectal cancer.

Objective

The aim of this study was to compare clinical efficacy between ESD and TEM for the treatment of early rectal cancer.

Methods

Between July 2008 and August 2011, 24 patients with early rectal cancers were treated by ESD (11) or TEM (13) at the Cancer Institute of São Paulo University Medical School (São Paulo, Brazil). Data were analyzed retrospectively according to database and pathological reports, with respect to en bloc resection rate, local recurrence, complications, histological diagnosis, procedure time and length of hospital stay.

Results

En bloc resection rates with free margins were achieved in 81.8 % of patients in the ESD group and 84.6 % of patients in the TEM group (p = 0.40). Mean tumor size was 64.6 ± 57.9 mm in the ESD group and 43.9 ± 30.7 mm in the TEM group (p = 0.13). Two patients in the TEM group and one patient in the ESD group had a local recurrence. The mean procedure time was 133 ± 94.8 min in the ESD group and 150 ± 66.3 min in the TEM group (p = 0.69). Mean hospital stay was 3.8 ± 3.3 days in the ESD group and 4.08 ± 1.7 days in the TEM group (p = 0.81).

Limitations

This was a non-randomized clinical trial with a small sample size and selection bias in treatment options.

Conclusion

ESD and TEM are both safe and effective for the treatment of early rectal cancer.
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Metadata
Title
Endoscopic submucosal dissection versus transanal endoscopic microsurgery for the treatment of early rectal cancer
Authors
Fábio Shiguehissa Kawaguti
Caio Sérgio Rizkallah Nahas
Carlos Frederico Sparapan Marques
Bruno da Costa Martins
Felipe Alves Retes
Raphael Salles S. Medeiros
Takemasa Hayashi
Yoshiki Wada
Marcelo Simas de Lima
Ricardo Sato Uemura
Sérgio Carlos Nahas
Shin-ei Kudo
Fauze Maluf-Filho
Publication date
01-04-2014
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 4/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-013-3302-z

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