Surgical considerations for local excision

Johnson, Dennis E.; Hoffman, John P.

doi:10.1016/s1053-4296(98)80036-2

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…The overall incidence of lymph node metastases is thought to be as high as 10–27% in this group although low grade lesions may only have a 12% incidence of lymph node metastasis [19,22]. The presence of lymph node metastases can be demonstrated with an accuracy of 60–80% preoperatively with transrectal endoscopic ultrasound [23]. In our series, 8 of the 10 patients with a post TEM diagnosis of T2 carcinoma had microscopic tumour clearance and no recurrence during the mean follow up period of 34.6 (14–50) months.…”

Section: Discussionmentioning

confidence: 99%

Transanal endoscopic microsurgery – lessons from a single UK centre series

et al. 2002

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Section: Discussionmentioning

confidence: 99%

Transanal endoscopic microsurgery – lessons from a single UK centre series

et al. 2002

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“…Recent advances in minimal access methods have improved the surgical technique of local excision for early stages of rectal cancer [13][14][15][16][17][18][19][20][21][22]. As compared to other local excision techniques, transanal endoscopic microsurgery (TEM) has proven to be associated with several advantages, chiefly, improved intraoperative visualization and the ability to perform full-thickness excision of the tumor with clear margins, together with perirectal fat and adjacent lymph nodes [23,24].…”

mentioning

confidence: 99%

Long‐term Results of Patients with pT2 Rectal Cancer Treated with Radiotherapy and Transanal Endoscopic Microsurgical Excision

Lezoche¹,

et al. 2002

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Anterior resection and abdomino-perineal resection are the surgical techniques used most frequently in the treatment of rectal cancer. Local recurrence rates of 10% to 14% are described after these conventional procedures. Preoperative neoadjuvant radiotherapy reduces local failure. Because local excision techniques can be applied to treat early rectal cancer in selected patients, we evaluated the results of preoperative high-dose radiotherapy and transanal endoscopic microsurgical excision (TEM) in patients with T2 rectal cancer. All patients underwent preoperative irradiation with 5,040 cGy, divided over 5 weeks. Forty days after completion of radiotherapy, the patients underwent complete full-thickness local excision of the rectal lesion including adjacent perirectal fat by TEM. The patients were followed for up to 8 years. Thirty-five patients, with pT2 rectal cancer as determined by pathological examination of the surgical specimen were enrolled in the present study. The tumors were responsive to preoperative radiotherapy in 82.8% of cases. No intraoperative complications and no conversion to open surgery were observed. No major complications and no mortality occurred during the 60-day postoperative period. Minor postoperative complications were observed in 5 patients (14.3%). The median follow-up of the patients was 38 months (range 24 to 96 months). One local recurrence (2.85%) was noted. The probability of surviving at 96 months after completion of treatment was 83%. Local excision by TEM combined with preoperative high-dose radiotherapy can achieve results similar to those observed after conventional surgery in patients with pT2 rectal cancer.

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“…A full-thickness transanal excision was performed in all patients according to techniques already published (11). Although the intent of the surgery was to achieve negative margins (R0), the main goal was to achieve gross excision.…”

Section: Surgerymentioning

confidence: 99%