Related Experiment Videos
Evaluation of local excision for sessile-type lower rectal tumors
Y Ishizaki1, Y Takeda, T Miyahara
1Department of Surgery and Pathology, Tokyo Rosai Hospital, Japan. ishizaki-yoichi@mx3.ttcn.ne.jp
Background/Aims:
A study was undertaken to evaluate the surgical morbidity and risk of recurrence in patients undergoing local excision for rectal carcinoma.
Methodology:
Twenty patients with well or moderately differentiated lesions less than 6 cm in diameter, which were difficult to remove endoscopically but had no clinically involved regional nodes, were eligible for local excision.
Results:
The transanal approach was simple and had few complications. After posterior parasacral excision, 3 patients developed rectocutaneous fistulas, and 1 of them died. None of the 12 patients with cancer extension limited to the lesser depth of the submucosa died of rectal cancer. Among 8 patients with cancer invasive into the greater depth of the submucosa or deeper, 5 underwent additional radical resection, and regional lymph node metastasis was revealed in 2.
Conclusions:
Transanal excision is suitable for curative resection of lower rectal tumors when the cancer extends only to the lesser depth of the submucosa. The procedure should be defined as a total excisional biopsy until the results of histologic examination are obtained.