Local Excision of Carcinomas of the Rectum, Anus, and Anal Canal

Abstract

Local resection has a place in the treatment of selected patients with carcinoma of the rectum, anus and anal canal. Selection depends on the ability of the surgeon to assess accurately the stage of the tumour. Favourable lesions are those which are small, exophytic, and mobile on the surrounding tissues. A transphincteric approach has been advocated tor these tumours, but this seems unnecessarily destructive. The present series consists of 18 highly selected patients who were treated by transanal local removal. There have been two recurrences, one of which has been treated by abdominoperineal resection and the other by further local excision. All of these patients were diagnosed clinically as suffering from carcinoma before operation. Patients who had a preoperative diagnosis of carcinoma and were later found to have benign adenomas, and patients who were diagnosed as benign and later found to have histological malignancy, have been excluded.

Outcome following local excision of T1 anal cancers—a systematic review

“…Overall, 1449 tumors were locally excised. Three studies [23][24][25], including in total twelve patients, had a short or incomplete follow-up and were not included in the pooled survival analysis. Only one study [14] with 53 patients did not report survival data.…”

“…Recurrence after local excision was reported in 15 studies, including in total 241 patients, and ranged between 0 and 100%. Four studies [11,14,23,25] including 67 patients had short or incomplete follow-up and were excluded, leaving 174 patients for pooled analysis. Follow-up in the pooled analysis ranged between 3 and 5 years.…”