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Local therapy of rectal tumors
B Mentges1, G Buess, D Schäfer
1Department of General Surgery, Eberhard Karls University Hospital, Tübingen, Germany.
Diseases of the Colon and Rectum
|August 1, 1996
Summary
Local therapy for early rectal cancer, using transanal endoscopic microsurgery, offers a less invasive option. This approach can improve quality of life by avoiding major surgery and potentially an artificial anus.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Rectal Cancer Treatment
Background:
- Local treatment for rectal tumors is gaining importance.
- Therapeutic strategies for early rectal cancer are evolving.
Purpose of the Study:
- To highlight the increasing significance of local treatment for rectal tumors.
- To discuss the changing therapeutic approaches for early-stage rectal cancer.
Main Methods:
- Transanal endoscopic microsurgery (TEM) was employed as the local surgical procedure.
- Indications included pT1 low-risk tumors and higher-stage tumors in high-risk patients or those refusing major surgery.
Main Results:
- TEM was used to locally excise 236 rectal adenomas and 98 carcinomas.
- Low complication rates were observed: 0.3% mortality, 5.5% reintervention for adenomas, and 8% for carcinomas.
- Histology confirmed stages pT1 (56), pT2 (27), and pT3 (15). Two recurrences in pT1 low-risk cases were successfully treated with secondary procedures.
Conclusions:
- Local therapy for rectal cancer can reduce high morbidity and mortality associated with traditional surgery.
- Improved quality of life is achievable, particularly by avoiding colostomy.
- The potential for successful secondary procedures in cases of recurrence should be considered.