[Transanal endoscopic rectal resection: immediate and long-term results].

Area of Science:

• Colorectal surgery
• Surgical oncology
• Gastroenterology

Background:

• Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for rectal tumor resection.
• Assessing TEM's outcomes for benign and early-stage malignant rectal tumors is crucial for treatment planning.

Purpose of the Study:

• To evaluate the efficacy and safety of transanal endoscopic microsurgery (TEM) for benign rectal tumors and early-stage rectal cancer (pT1N0M0).

Main Methods:

• Analysis of 87 transanal endoscopic resections: 35 for benign tumors and 52 for cT1N0M0 rectal cancer.
• Data collected since 2012, focusing on intraoperative complications, postoperative outcomes, and long-term recurrence rates.

Main Results:

• For rectal cancer (pT1N0M0), complication rates were low (3.8% perforation, 3.8% bleeding). Relapse-free and overall survival rates were high (0.923 and 0.926, respectively).
• Four patients (7.7%) experienced recurrence, associated with pT2N0M0 stage, anterior wall location, and higher tumor position.
• For benign tumors, complication rates were also low (4.3% perforation, 4.3% anastomotic leakage), with a 8.7% recurrence rate for villous tumors.

Conclusions:

• Transanal endoscopic resection is an effective treatment for benign rectal tumors and pT1N0M0 rectal cancer, demonstrating favorable survival and low complication rates.
• Tumor stage (pT2N0M0), anterior rectal wall location, and a distance >10 cm from the anus are identified as risk factors for recurrence.