Transanal endoscopic microsurgery resection of rectal tumors: outcomes and recommendations.

Details

Serval ID
serval:BIB_0AF18EC027B2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Transanal endoscopic microsurgery resection of rectal tumors: outcomes and recommendations.
Journal
Diseases of the colon and rectum
Author(s)
Tsai B.M., Finne C.O., Nordenstam J.F., Christoforidis D., Madoff R.D., Mellgren A.
ISSN
1530-0358 (Electronic)
ISSN-L
0012-3706
Publication state
Published
Issued date
01/2010
Peer-reviewed
Oui
Volume
53
Number
1
Pages
16-23
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Transanal endoscopic microsurgery provides a minimally invasive alternative to radical surgery for excision of benign and malignant rectal tumors. The purpose of this study was to review our experience with transanal endoscopic microsurgery to clarify its role in the treatment of different types of rectal pathology.
A prospective database documented all patients undergoing transanal endoscopic microsurgery from October 1996 through June 2008. We analyzed patient and operative factors, complications, and tumor recurrence. For recurrence analysis, we excluded patients with fewer than 6 months of follow-up, previous excisions, known metastases at initial presentation, and those who underwent immediate radical resection following transanal endoscopic microsurgery.
Two hundred sixty-nine patients underwent transanal endoscopic microsurgery for benign (n = 158) and malignant (n = 111) tumors. Procedure-related complications (21%) included urinary retention (10.8%), fecal incontinence (4.1%), fever (3.8%), suture line dehiscence (1.5%), and bleeding (1.5%). Local recurrence rates for 121 benign and 83 malignant tumors were 5% for adenomas, 9.8% for T1 adenocarcinoma, 23.5% for T2 adenocarcinoma, 100% for T3 adenocarcinoma, and 0% for carcinoid tumors. All 6 (100%) recurrent adenomas were retreated with endoscopic techniques, and 8 of 17 (47%) recurrent adenocarcinomas underwent salvage procedures with curative intent.
Transanal endoscopic microsurgery is a safe and effective method for excision of benign and malignant rectal tumors. Transanal endoscopic microsurgery can be offered for (1) curative resection of benign tumors, carcinoid tumors, and select T1 adenocarcinomas, (2) histopathologic staging in indeterminate cases, and (3) palliative resection in patients medically unfit or unwilling to undergo radical resection.
Keywords
Adenocarcinoma/pathology, Adenocarcinoma/surgery, Adult, Aged, Aged, 80 and over, Anal Canal, Colectomy/methods, Female, Humans, Male, Microsurgery, Middle Aged, Rectal Neoplasms/pathology, Rectal Neoplasms/surgery, Retrospective Studies, Treatment Outcome
Pubmed
Web of science
Create date
24/02/2010 11:13
Last modification date
12/10/2019 5:26
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