Related Experiment Videos
[Local excision of rectal tumors]
Francesco Stipa1, Vincenzo Ziparo, Giuseppe Casula
1III Dipartimento di Chirurgia, Ospedale S. Giovanni, Roma.
Chirurgia Italiana
|August 24, 2002
Summary
Local excision effectively treats rectal adenomas and early cancers, with low recurrence for T1 stage. Advanced T2/T3 rectal tumors require neoadjuvant therapy or palliative local excision.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Colorectal Surgery
Background:
- Local excision is a standard treatment for sessile adenomas and early rectal adenocarcinomas.
- The role of local excision for transmural rectal carcinomas (T2 and T3) remains debated, lacking randomized controlled trials.
Purpose of the Study:
- To evaluate the early and long-term outcomes of local excision for rectal adenomas and carcinomas.
- To determine recurrence rates and influencing factors for different tumor stages.
Main Methods:
- A consecutive series of 160 patients undergoing local excision for rectal lesions were analyzed.
- Data collected included patient demographics, tumor type, adjuvant therapy, complications, and recurrence rates.
Main Results:
- Overall local recurrence rates were 3% for adenomas and 24% for carcinomas.
- For adenocarcinomas, recurrence correlated with staging, margin status, and adjuvant therapy.
- No recurrences were observed in T2 patients receiving neoadjuvant treatment, while T3 patients showed differences compared to radical surgery.
Conclusions:
- Local excision, especially transanal endoscopic microsurgery, is beneficial for rectal adenomas and T1 carcinomas.
- T2 rectal tumors warrant preoperative chemoradiotherapy, and T3 tumors are best managed with palliative transanal endoscopic microsurgery.