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Erschienen in:
01.06.2008
Long-term Follow-up of Local Rectal Cancer Surgery by Transanal Endoscopic Microsurgery
Erschienen in: World Journal of Surgery | Ausgabe 6/2008
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Background
In 1997 we launched a prospective program of transanal endoscopic microsurgery (TEM) for the treatment of rectal cancer.
Methods
Suitability for TEM was based on endorectal ultrasound results, classified as follows: (I) benign tumors; (II) adenocarcinomas uT0 and uT1 with uN0; (III) adenocarcinomas uT2- uN0, low histological grade with intention to cure; and (IV) advanced stage adenocarcinomas with palliative care
Results
Transanal endoscopic microsurgery was performed in 218 patients: 122 adenomas, and 96 adenocarcinomas: group II–72, group III–19, and group IV–5. Follow-up was >24 months (median 59 months) in 61 patients. Nine were lost to follow-up, and so 52 patients were studied: group II–38, group III–11, and group IV–3. The Kaplan-Meier probability of nonrecurrence of adenocarcinoma by group was 93% in tumors in situ (Tis) and T1; and 77.8% in T2. The Kaplan-Meier probability of survival by group was 100% in Tis and T1 and 82% in T2.
Conclusions
Rates of recurrence and long-term survival in Tis and T1 adenocarcinomas treated with TEM are similar to those in previously published reports using conventional surgery. Further studies are required in T2 adenocarcinomas to determine a definitive strategy.