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Transanal endoscopic microsurgery for rectal tumors: the St. Mary's experience
Emmanouil Zacharakis1, Simon Freilich, Sushil Rekhraj
1Department of Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, 10th Floor, QEQM Wing, St Mary's Campus, Praed St, London W2 1NY, UK.
Background:
The aim of this study is to describe a single institution's experience in the use of transanal endoscopic microsurgery for rectal tumors.
Methods:
Between 1996 and 2005, transanal endoscopic microsurgery was performed in 76 patients. The histologic diagnosis was adenoma in 48 and adenocarcinoma in 28 patients.
Results:
Clear resection margins were achieved in 71 of 74 patients (95.9%). Overall morbidity was 18.9% because 14 patients developed minor (10 patients) or major complications (4 patients). During the follow-up, benign tumor recurrence was detected in 3 patients (6.3%). The recurrence rates among patients with T1, T2, and T3 malignant tumors were 7.1%, 42.8%, and 66.6%, respectively.
Comments:
Transanal endoscopic microsurgery is a safe and feasible technique with low incomplete excision rates and may be the preferred method in patients with benign rectal tumors. Its role in the management of malignant tumors should be limited to selected patients with T1 lesions.
