Ann Coloproctol.  2017 Feb;33(1):23-27. 10.3393/ac.2017.33.1.23.

Transanal Endoscopic Microsurgery for Patients With Rectal Tumors: A Single Institution's Experience

• Dulskas A
• Kilius A
• Petrulis K
• Samalavicius NE

• KMID: 2377386
• DOI: http://doi.org/10.3393/ac.2017.33.1.23

Abstract

PURPOSE
The purpose of this study was to look at our complication rates and recurrence rates, as well as the need for further radical surgery, in treating patients with benign and early malignant rectal tumors by using transanal endoscopic microsurgery (TEM).
METHODS
Our study included 130 patients who had undergone TEM for rectal adenomas and early rectal cancer from December 2009 to December 2015 at the Department of Surgical Oncology, National Cancer Institute, Lithuania. Patients underwent digital and endoscopic evaluation with multiple biopsies. For preoperative staging, pelvic magnetic resonance imaging or endorectal ultrasound was performed. We recorded the demographics, operative details, final pathologies, postoperative lengths of hospital stay, postoperative complications, and recurrences.
RESULTS
The average tumor size was 2.8 ± 1.5 cm (range, 0.5-8.3 cm). 102 benign (78.5%) and 28 malignant tumors (21.5%) were removed. Of the latter, 23 (82.1%) were pT1 cancers and 5 (17.9%) pT2 cancers. Of the 5 patients with pT2 cancer, 2 underwent adjuvant chemoradiotherapy, 1 underwent an abdominoperineal resection, 1 refused further treatment and 1 was lost to follow up. No intraoperative complications occurred. In 7 patients (5.4%), postoperative complications were observed: urinary retention (4 patients, 3.1%), postoperative hemorrhage (2 patients, 1.5%), and wound dehiscence (1 patient, 0.8%). All complications were treated conservatively. The mean postoperative hospital stay was 2.3 days.
CONCLUSION
TEM in our experience demonstrated low complication and recurrence rates. This technique is recommended for treating patients with a rectal adenoma and early rectal cancer and has good prognosis.

Keyword

Transanal endoscopic microsurgery; Rectal adenoma; Early rectal cancer; Recurrence

MeSH Terms

Adenoma
Biopsy
Chemoradiotherapy, Adjuvant
Demography
Humans
Intraoperative Complications
Length of Stay
Lithuania
Lost to Follow-Up
Magnetic Resonance Imaging
National Cancer Institute (U.S.)
Pathology
Postoperative Complications
Postoperative Hemorrhage
Prognosis
Rectal Neoplasms*
Recurrence
Transanal Endoscopic Microsurgery*
Ultrasonography
Urinary Retention
Wounds and Injuries