TITLE:
Local Excision of Early Rectal Cancer by Transanal Endoscopic Microsurgery (TEM): The 23-Year Experience of a Single Centre
AUTHORS:
Mario Guerrieri, Monica Ortenzi, Maria Michela Cappelletti Trombettoni, Indrit Kubolli, Roberto Ghiselli
KEYWORDS:
Transanal Endoscopic Microsurgery, Rectal Cancer
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.11,
October
23,
2015
ABSTRACT: Aim: Transanal endoscopic microsurgery (TEM) is an effective, minimally invasive
alternative approach to traditional surgery. This study reviews the characteristics
of a series of patients affected by early rectal cancer and discusses the results
of this treatment. Methods: From 1992 to 2014, 187 patients with rectal cancer staged
as pT1 by preoperative endorectal ultrasound, computerized tomography and/or magnetic
resonance imaging were treated by TEM at our institution. We analysed age, gender,
size of lesion, distance from the anal verge, histological grading and stage. Furthermore we considered operative time,
intra and post-operative complications and hospital stay. Patients were also enrolled
in a tight follow-up for recurrence and survival. Results: There were no intraoperative complications or
conversions to other procedures. There were minor complications (partial suture
dehiscence, stool incontinence, rectal haemorrhage) in 24 patients (12.8%) and a
major complication (perianal phlegmon) in one (1.5%). Two (5%) of the 40 patients
with pT3 disease before neoadjuvant therapy experienced a local recurrence and one (2.5%) died for metastasis. Conclusion:
TEM is a safe technique characterized by low morbidity and mortality and excellent
oncological outcomes. These advantages, coupled with its ability to be applied to
a strikingly high proportion of rectal tumours, suggest that it should be considered
as the gold standard approach to early rectal cancer in accurately selected patients.