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Updated: Jul 6, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Long-term follow-up of local rectal cancer surgery by transanal endoscopic microsurgery
Xavier Serra-Aracil1, Helena Vallverdú, Jordi Bombardó-Junca
1Department of General and Digestive Surgery, Corporació Sanitaria Parc Taulí, Parc Taulí s/n, 08208, Sabadell, Barcelona, Spain. jserraa@cauli.cat
Background:
In 1997 we launched a prospective program of transanal endoscopic microsurgery (TEM) for the treatment of rectal cancer.
Methods:
Suitability for TEM was based on endorectal ultrasound results, classified as follows: (I) benign tumors; (II) adenocarcinomas uT0 and uT1 with uN0; (III) adenocarcinomas uT2- uN0, low histological grade with intention to cure; and (IV) advanced stage adenocarcinomas with palliative care
Results:
Transanal endoscopic microsurgery was performed in 218 patients: 122 adenomas, and 96 adenocarcinomas: group II-72, group III-19, and group IV-5. Follow-up was >24 months (median 59 months) in 61 patients. Nine were lost to follow-up, and so 52 patients were studied: group II-38, group III-11, and group IV-3. The Kaplan-Meier probability of nonrecurrence of adenocarcinoma by group was 93% in tumors in situ (Tis) and T1; and 77.8% in T2. The Kaplan-Meier probability of survival by group was 100% in Tis and T1 and 82% in T2.
Conclusions:
Rates of recurrence and long-term survival in Tis and T1 adenocarcinomas treated with TEM are similar to those in previously published reports using conventional surgery. Further studies are required in T2 adenocarcinomas to determine a definitive strategy.
