Transanal endoscopic microsurgery for the treatment of selected patients with distal rectal cancer: 15 years experience
| Autor: | S. Bartolacci, M. Baldarelli, E. Lezoche, F G Grillo Ruggeri, L. Organetti, Giovanna Mantello, Mario Guerrieri |
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| Rok vydání: | 2007 |
| Předmět: |
transanal endoscopic microsurgery
Male medicine.medical_specialty Antimetabolites Antineoplastic Microsurgery Colorectal cancer medicine.medical_treatment Adenocarcinoma Disease-Free Survival tem transanal endoscopic microsurgery Postoperative Complications tem medicine Combined Modality Therapy Humans distal rectal cancer radiochemotherapy Neoadjuvant therapy Aged Neoplasm Staging Retrospective Studies medicine.diagnostic_test business.industry Rectal Neoplasms Patient Selection Cancer Retrospective cohort study Middle Aged medicine.disease Neoadjuvant Therapy Endoscopy Surgery Female Fluorouracil Neoplasm Recurrence Local business Abdominal surgery |
| Zdroj: | Surgical endoscopy. 22(9) |
| ISSN: | 1432-2218 |
| Popis: | Local therapy for early rectal cancer is a valid alternative to the classical radical operation, which has a higher morbidity and mortality rate. The use of high-dose preoperative radiation appears to enhance the options for sphincter-saving surgery even for T2-T3 rectal cancer patients with effective local control. The authors report their experience with transanal endoscopic microsurgery (TEM) used to manage selected cases of distal rectal cancer without evidence of nodal or distant metastasis (N0-M0).The study enrolled 196 patients with rectal cancer (51 T1, 84 T2, and 61 T3). All the patients staged preoperatively as T2 and T3 underwent preoperative high-dose radiotherapy, and since 1997, patients younger than 70 years in good general condition also have undergone preoperative chemotherapy.Minor complications were observed in 17 patients (8.6%) and major complications in only 3 patients (1.5%). The definitive histology was 33 pT0 (17%), 73 pT1 (37%), 66 pT2 (34%), and 24 pT3 (12%). Eight patients (5 pT2 and 3 pT3) experienced local recurrence (4.1%). The rectal cancer-specific survival rate at the end of the follow-up period was 100% for pT1, 90% for pT2, and 77% for pT3 patients.Patients with T1 cancer and favorable histologic features may undergo local excision alone, whereas those with T2 and T3 rectal cancer require preoperative radiochemotherapy. The results in the authors' experience after TEM appear not to be substantially different in terms of local recurrence and survival rate from those described for conventional surgery. |
| Databáze: | OpenAIRE |
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