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[Local excision of rectal carcinoma]
A Heintz1, M Mörschel, J Seifert
1Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes-Gutenberg-Universität Mainz.
Zentralblatt Fur Chirurgie
|January 1, 1996
Summary
Local excision of early rectal cancer (T1) is effective when adequate tumor-free margins are confirmed histologically. This rectal cancer treatment avoids recurrence in most low-risk cases, supporting its justification.
Area of Science:
- Oncology
- Surgical Gastroenterology
- Diagnostic Imaging
Context:
- Rectal carcinoma treatment outcomes.
- Comparison of diagnostic methods for tumor infiltration.
- Evaluation of local excision efficacy for early-stage rectal cancer.
Purpose:
- To assess the oncological safety and efficacy of local excision for "low risk" T1 rectal carcinomas.
- To compare endosonography with digital rectal examination for tumor infiltration assessment.
- To determine the impact of surgical margins on local recurrence rates after local excision.
Summary:
- 109 patients with rectal carcinoma underwent local excision (36 with subsequent radical operation).
- Endosonography outperformed digital rectal examination in assessing tumor infiltration.
- Local excision of "low risk" T1 rectal carcinomas with adequate margins showed no local recurrence (0/34), while inadequate margins led to recurrence in 2/10 patients.
Impact:
- Local excision is a viable and justified treatment option for selected "low risk" T1 rectal carcinomas.
- Histological confirmation of adequate tumor-free margins is crucial for preventing local recurrence.
- Endosonography improves the accuracy of staging for rectal cancer compared to digital rectal examination.