Transanal endoscopic microsurgery in treatment of rectal adenomas and T1 low-risk carcinomas

Background: Transanal endoscopic microsurgery as a local therapy option for rectal neoplasms is a tissuesparingtechnique that protects the anal sphincter. The present retrospective analysis reportsthe course of observation after local excision of adenomas and T1 low-risk carcinomas usingtransanal endoscopic microsurgery. Methods: In a retrospective analysis we examined data on 279 patients for local recurrence. A total of144 patients had a rectal adenoma (n = 103) or a R0 resection of low-risk T1 carcinomas (n =41). In this collective, we also examined parameters concerning perioperative management,complications, intraoperative blood loss and duration of hospital stay. Results: Patients with adenoma were on average 64.9 (range 37 to 90) years old; 83.5% of theadenomas were located 3 to 11 cm from the anocutaneous line. In adenoma patients therecurrence rate was 2.9% for an observation period of 21.8 months. The postoperative coursewas without any complications in 98.1% of patients.Patients with T1 low-risk carcinoma were 64.6 (range 30 to 89) years old. In all cases, an R0resection could be performed. The recurrence rate was 9.8% for an observation period of 34.4months. In this group the postoperative course was free of complications in 97.6% ofpatients. Conclusions: The high efficacy of transanal endoscopic microsurgery ensures minimally invasive treatmentof adenomas and low-risk T1 carcinomas with low complication rates and a low rate oftherapeutic failure.

via World Journal of Surgical Oncology