Transanal endoscopic microsurgery for rectal cancer

Graaf, Eelco J. R. de; Doornebosch, Pascal G.; Stassen, Laurents P. S.; Debets, J. M. H.; Tetteroo, G. W. M.; Hop, Wim C. J.

doi:10.1016/s0959-8049(02)00050-3

Cited by 60 publications

(47 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…62,[87][88][89] Several groups have reported their experience with TEM in patients with early rectal cancers (Table 4). 38,39,44,45,86,[90][91][92][93][94][95][96][97][98][99] Baartrup and colleagues 86 retrospectively studied 72 patients 45 Tot a l - 97 Tot a l - Tot a l -…”

Section: Early Rectal Adenocarcinomasmentioning

confidence: 99%

Transanal endoscopic microsurgery: a review

Heidary

Phang

Raval

et al. 2014

cjs

View full text Add to dashboard Cite

Section: Early Rectal Adenocarcinomasmentioning

confidence: 99%

Transanal endoscopic microsurgery: a review

Heidary

Phang

Raval

et al. 2014

cjs

View full text Add to dashboard Cite

“…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).…”

mentioning

confidence: 99%

Progression and Tumor Heterogeneity Analysis in Early Rectal Cancer

Lips¹,

Eijk²,

Graaf

et al. 2008

Clinical Cancer Research

View full text Add to dashboard Cite

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.

show abstract

“…[3][4][5][6][7][8][9][10][11] One possible reason why TEM may not be as widely used in the UK as it might be could be the capital cost of the equipment; this may have as great an impact on the introduction of a new procedure as any perceived clinical benefits. The number of centres providing the technique and training in its use may also limit its wider uptake.…”

Section: Discussionmentioning

confidence: 99%

Transanal endoscopic microsurgery – impact on the practice of a colorectal surgeon in a district general hospital

Mihai

Borley²

2005

Ann R Coll Surg Engl

View full text Add to dashboard Cite

INTRODUCTIONThe objective was to assess the impact on the management of colorectal patients treated in a district general hospital within the first year after the introduction of transanal endoscopic microsurgery (TEM).PATIENTS AND METHODS Data were collected for consecutive unselected patients who underwent TEM. Comparative data were derived from a matched group of patients who underwent anterior resection, peranal procedures (PAR) or transanal resection (TAR) in this unit.RESULTS Twenty-two patients underwent TEM (11 men and 11 women; aged, 29-87 years; median, 75 years). Eighteen patients had a pre-operative diagnosis of benign rectal neoplasms; three were found to have invasive carcinoma, which might have been missed during TAR. Four patients had a pre-operative diagnosis of rectal cancer and TEM provided local tumour control in three cases. The operating time ranged between 20-150 min (mean, 65 min; median, 57 min). Hospital stay ranged between 0-10 days (mean, 3.7 days; median, 3 days), with a total of 97 in-patient days for the entire group of patients. Twenty-four operations were performed (22 TEM and two salvage anterior resections), with an estimated cost of £1544 for consumables used. Alternative treatments in the absence of TEM were considered to involve 10 anterior resections, 5 closures of ileostomy, 30 TAR procedures and one PAR procedure, with an estimated 306 days of in-patient admission, 46 operations and £6245 spent on consumables.CONCLUSIONS Availability of TEM allows more efficient treatment for a significant number of patients with rectal tumours. The cost of the equipment is offset by a significant decrease in the length of in-patient admissions.

show abstract

Transanal endoscopic microsurgery for rectal cancer

Cited by 60 publications

References 29 publications

Transanal endoscopic microsurgery: a review

Transanal endoscopic microsurgery: a review

Progression and Tumor Heterogeneity Analysis in Early Rectal Cancer

Transanal endoscopic microsurgery – impact on the practice of a colorectal surgeon in a district general hospital

Contact Info

Product

Resources

About