Technique and results of transanal endoscopic microsurgery in early rectal cancer

Bueß, G.; Mentges, B.; Manncke, K.; Starlinger, M; Becker, H. D.

doi:10.1016/0002-9610(92)90254-o

Cited by 255 publications

(138 citation statements)

References 7 publications

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“…1,2 The technique is safe and effective for removal of rectal adenomas and is an alternative to radical rectal resection in carefully selected patients with rectal cancer. [3][4][5] Transanal endoscopic microsurgery involves prolonged anal dilation with insertion of a rectoscope 40 mm in diameter and insufflation of the rectum.…”

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confidence: 99%

Transanal endoscopic microsurgery: impact on fecal incontinence and quality of life

Planting

Phang²,

Raval³

et al. 2013

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Background: Anal dilation during tumour excision with transanal endoscopic microsurgery (TEM) has caused concerns regarding postoperative anal function. We sought to determine whether TEM affects anorectal function and quality of life. Results: Forty patients received TEM; 30 of them met all inclusion criteria and agreed to participate. The median age was 70 (42-93) years, and median follow-up time between the interview and the operation was 365 (55-712) days. Tumours excised included 19 adenomas, 8 carcinomas and 3 carcinoid tumours. The median distance from the tumour to the anal verge was 6.5 (2-13) cm. Median length of stay was 1 (0-12) day. For most aspects of quality of life, there were no detectable differences after surgery. The EORTC QLQ-C30 showed a significant improvement in diarrhea (27.8 v. 10, p = 0.002). The FIQL scores improved with surgery (3.59 v. 3.85, p = 0.020). There was no difference in pre-versus postoperative FISI scores (6.7 v. 6.3, p = 0.93). Methods Conclusion:Despite a large operating rectoscope, TEM improves quality of life related to fecal incontinence and does not have a negative impact on fecal continence.Contexte : La dilatation de l'anus au cours de l'excision d'une tumeur par microchirurgie endoscopique transanale (MET) soulève des préoccupations quant à la fonction anale postopératoire. Nous avons cherché à déterminer si la MET a un effet sur la fonction anorectale et la qualité de vie.

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confidence: 99%

Transanal endoscopic microsurgery: impact on fecal incontinence and quality of life

Planting

Phang²,

Raval³

et al. 2013

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“…Approximately 25% of these cases are rectal cancers, and the incidence of its benign precursor lesion, adenomas, is far higher. Total mesorectal excision is the gold standard to treat carcinomas (2); transanal endoscopic microsurgery (TEM) is the method of choice to treat sessile adenomas (3,4). Although it has not yet been proven, T1 rectal carcinomas may be good candidates for TEM without compromising oncological outcome (5 -7).…”

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confidence: 99%

Progression and Tumor Heterogeneity Analysis in Early Rectal Cancer

Lips¹,

Eijk²,

Graaf

et al. 2008

Clinical Cancer Research

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Purpose: Adequate preoperative staging of large sessile rectal tumors requires identifying adenomas that already contain an invasive focus, specifically those that are growing in or beyond the submucosa. We systematically compared chromosomal instability patterns in adenoma and carcinoma fractions of the same lesion to assess specific steps in rectal tumor progression. Experimental Design: We analyzed 36 formalin-fixed, paraffin-embedded tumors. Both the adenoma and carcinoma fractions were typed with single nucleotide polymorphism arrays and compared with 21 previously described pure adenomas. Eighteen cases were included in an intratumor heterogeneity analysis. Results: Five specific ''malignant''events (gain of 8q, 13q, and 20q and loss of 17p and 18q) and aberrant staining for p53 and SMAD4 were all increased in the adenoma fractions of carcinoma cases compared with pure adenomas. Paired analysis revealed that 31% of the samples had an equal amount of malignant aberrations in their adenoma and carcinoma fractions, whereas 25% had one and 33% had two or more extra malignant events in the carcinoma fraction. Analysis of three core biopsies per patient showed a large degree of intratumor heterogeneity. However, the number of malignant aberrations in the biopsy with the most aberrations per tumor correlated with the corresponding adenoma or carcinoma fraction (r = 0.807; P < 0.001).Conclusion: Five specific chromosomal aberrations, combined with immunohistochemistry for p53 and SMAD4, can predict possible progression of sessile rectal adenomas to early rectal cancer and can, after validation studies, be added to preoperative staging. Preferably, three biopsies should be taken from each tumor to address intratumor heterogeneity.

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“…Other studies have also demonstrated good results with low recurrence and high survival for selected pT1N0 rectal adenocarcinomas treated by TEM alone 2,4,8,13,20,21,36 . In the advent that pathological examination reveals a pT1 lesion with unfavorable features or a more advanced lesion the authors recommend complementary treatment with radical surgery and/or CMT.…”

Section: Early Rectal Cancersmentioning

confidence: 89%

Transanal endoscopic microsurgery (TEM): a minimally invasive procedure for treatment of selected rectal neoplasms

Nahas

Marques

et al. 2010

ABCD, arq. bras. cir. dig.

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HEADINGS -Colorectal surgery. Combined modality therapy. Carcinoid.ABSTRACT -Transanal endoscopic microsurgery (TEM) provides a minimally invasive alternative to radical surgery for excision of benign and malignant rectal tumors. TEM aims to provide an alternative to conventional abdominal surgery (low anterior resection or abdominoperineal amputations), which carries not inconsiderable morbidity and mortality. Based on review of the literature and in the authors experience, this review present the method and indications for TEM.RESUMO -A microcirurgia endoscópica transanal (TEM) é procedimento alternativo minimamente invasivo ao tratamento cirúrgico radical para excisão de tumores benignos e malignos do reto. Ela oferece possibilidade operatória aos procedimentos cirúrgicos convencionais (ressecção anterior baixa ou amputações abdominoperineais), as quais acarretam alta morbimortalidade. Baseada na revisão da literatura e na experiência própria dos autores, esta revisão tem por objetivo apresentar o método e as indicações para a TEM.

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Technique and results of transanal endoscopic microsurgery in early rectal cancer

Cited by 255 publications

References 7 publications

Transanal endoscopic microsurgery: impact on fecal incontinence and quality of life

Transanal endoscopic microsurgery: impact on fecal incontinence and quality of life

Progression and Tumor Heterogeneity Analysis in Early Rectal Cancer

Transanal endoscopic microsurgery (TEM): a minimally invasive procedure for treatment of selected rectal neoplasms

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