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Updated: Jul 16, 2026

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Early rectal cancer: definition and management
Emanuele Lezoche1, Maddalena Baldarelli, Angelo De Sanctis
1Department of Surgery Paride Stefanini, II Clinica Chirurgica, University La Sapienza, Rome, Italy. emanuele.lezoche@uniroma1.it
Transanal endoscopic microsurgery offers favorable outcomes for early-stage rectal cancer. This minimally invasive approach shows low recurrence and high survival rates, comparable to traditional surgery.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Local excision is an alternative to radical resection for early-stage rectal cancer (T1-T2-N0).
- Its role in managing these patients remains a significant surgical consideration.
Purpose of the Study:
- To evaluate the outcomes of 135 patients with early-stage low rectal cancer.
- Treatment involved local excision via transanal endoscopic microsurgery (TEM).
- T2 stage patients also received neoadjuvant therapy.
Main Methods:
- 135 patients with T1-T2-N0-M0 rectal cancer were included.
- Histological staging revealed pT0 (17.8%), pT1 (48.8%), and pT2 (33.4%) disease.
- Median follow-up was 78 months.
Main Results:
- Minor complications occurred in 8.8% of patients; major complications in 1.5%.
- Local recurrence was observed in 4 patients; distal metastasis in 2 (all T2 preoperatively).
- Disease-free survival rates were 100% for T1 and 93% for T2 patients.
Conclusions:
- Transanal endoscopic microsurgery yields long-term results for early-stage rectal cancer.
- Outcomes regarding local recurrence and survival are comparable to conventional total mesorectal excision.
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