Transanal endoscopic rectal resection: immediate and long-term results

• Published in: Hirurgija (Moskva) no. 1; p. 30
• Main Authors: Maslov, A A, Gevorkyan, Yu A, Soldatkina, N V, Dashkov, A V, Poluektov, S I, Kolesnikov, V E, Kaymakchi, D O, Snezhko, A V
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2022
• Subjects: Digestive System Surgical Procedures; Humans; Microsurgery; Neoplasm Recurrence, Local; Rectal Neoplasms - surgery; Rectum - surgery; Retrospective Studies; Transanal Endoscopic Surgery; Treatment Outcome; recurrence; benign rectal tumors; transanal endoscopic rectal resection; rectal cancer
• ISSN: 0023-1207
• DOI: 10.17116/hirurgia202201130

To analyze the results of transanal endoscopic microsurgery in patients with rectal tumors. We analyzed 87 transanal endoscopic resections of rectal benign tumors (35 patients) and rectal cancer cT1N0M0 (52 patients) for the period since 2012. There were 2 (3.8%) intraoperative intestinal wall perforations into abdominal cavity and 2 (3.8%) postoperative bleedings among patients with rectal cancer. Four (7.7%) patients developed recurrent rectal cancer (pT1N0M0 - 1 patient, pT2N0M0 - 3 patients; by tumor grades: G1 - 2 patients, G2 - 2 patients) within 1.6-5.2 years. All recurrent tumors were located on anterior rectal wall. In patients with rectal cancer, cumulative relapse-free survival was 0.923 (standard error 0.037), cumulative overall survival - 0.926 (standard error 0.043). There was 1 (4.3%) intraoperative intestinal wall perforation among patients with benign rectal tumors. Postoperative anastomotic leakage occurred in 1 (4.3%) patient. Recurrent benign tumors occurred in 2 (8.7%) patients with villous rectal tumors. No relapses were observed in patients with rectal adenomas ( =1.0). Transanal endoscopic rectal resection is effective for benign rectal tumors and rectal cancer pT1N0M0 with high relapse-free and overall survival and low complication rate. Risk factors of recurrence are tumor stage pT2N0M0, tumor location on anterior wall and distance from the anus over 10 cm.