Transanal Endoscopic Microsurgery Versus Conventional Transanal Excision for Patients With Early Rectal Cancer

Christoforidis, Dimitrios; Cho, Hyeon Min; Dixon, Matthew R.; Mellgren, Anders; Madoff, Robert D.; Finne, Charles O.

doi:10.1097/sla.0b013e3181a3e54b

Cited by 186 publications

(90 citation statements)

References 25 publications

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“…Comparative studies of TEM and TAE for early rectal cancers demonstrated fewer resections with positive margins and lower local recurrence rates with TEM. In a study of patients with early rectal cancers, Christoforidis and colleagues 63 found a lower local recurrence rate in patients undergoing TEM than in those who had TAE, although the difference was not significant (12% v. 22%, p = 0.37). They also found better tumour resection in patients who underwent TEM, with fewer positive margins in these patients than in those who underwent TAE (37% v. 19%, p = 0.001).…”

Section: Early Rectal Adenocarcinomasmentioning

confidence: 99%

Transanal endoscopic microsurgery: a review

Heidary

Phang

Raval

et al. 2014

cjs

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Section: Early Rectal Adenocarcinomasmentioning

confidence: 99%

Transanal endoscopic microsurgery: a review

Heidary

Phang

Raval

et al. 2014

cjs

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“…On the other hand, the published results on the oncological outcome following TEM remain controversial, since other studies [85] reported favorable results with local recurrence rates lower than 10%, others [86] confirmed the lower local recurrence rates following TEM compared to the transanal local excision (18.5% vs 27.7%) but without statistical significance, others [87] stated alarming figures for local recurrence following TEM for T1 rectal tumors, while local recurrence rates as high as 20.5% have also been reported [88] . In an attempt to evaluate further the above findings, both Tytherleigh et al [89] in 2008, as-well-as Bach et al [90] in 2009, offered possible explanations for these unfavorable results.…”

Section: Long-term Results Studies On the Oncological Outcome Followimentioning

confidence: 93%

Low rectal cancer: Sphincter preserving techniques-selection of patients, techniques and outcomes

Dimitriou

Michail

Moris

et al. 2015

WJGO

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Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity and to improve both the oncological as well as the functional outcomes, have been emerged. Literature suggest that when the intersphincteric resection is applied in T1-3 tumors located within 30-35 mm from the anal verge, is technically feasible, safe, with equal oncological outcomes compared to conventional surgery and acceptable quality of life. The Anterior Perineal PlanE for Ultra-low Anterior Resection technique, is not disrupting the sphincters, but carries a high complication rate, while the reports on the oncological and functional outcomes are limited. Transanal Endoscopic MicroSurgery (TEM) and TransAnal Minimally Invasive Surgery (TAMIS) should represent the treatment of choice for T1 rectal tumors, with specific criteria according to the NCCN guidelines and favorable pathologic features. Alternatively to the standard conventional surgery, neoadjuvant chemo-radiotherapy followed by TEM or TAMIS seems promising for tumors of a local stage T1sm2-3 or T2. Transanal Total Mesorectal Excision should be performed only when a board approved protocol is available by colorectal surgeons with extensive experience in minimally invasive and transanal endoscopic surgery. Core tip: The present review presents the most recent advances in the field of sphincter preserving surgery for the treatment of low rectal cancer patients, providing indications, patients' selection, surgical techniques, multimodality approaches, postoperative course and oncological and functional outcomes. In particular, the review focuses on data deriving from prospective EDITORIAL

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“…TEM has been proved to be safe and effective in several case series [141,142]. Although the evidence regarding TEM is limited, it does appear to result in fewer recurrences compared with conventional transanal excision [143,144].…”

Section: 9% [Consensus])mentioning

confidence: 99%

Laparoscopic extraperitoneal rectal cancer surgery: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES)

et al. 2011

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Background The laparoscopic approach is increasingly applied in colorectal surgery. Although laparoscopic surgery in colon cancer has been proved to be safe and feasible with equivalent long-term oncological outcome compared to open surgery, safety and long-term oncological outcome of laparoscopic surgery for rectal cancer remain controversial. Laparoscopic rectal cancer surgery might be efficacious, but indications and limitations are not clearly defined. Therefore, the European Association for Endoscopic Surgery (EAES) has developed this clinical practice guideline. Methods An international expert panel was invited to appraise the current literature and to develop evidence-based recommendations. The expert panel constituted for a consensus development conference in May 2010. Thereafter, the recommendations were presented at the annual congress of the EAES in Geneva in June 2010 in a plenary session. A second consensus process (Delphi process) of the recommendations with the explanatory text was necessary due to the changes after the consensus conference. Results Laparoscopic surgery for extraperitoneal (midand low-) rectal cancer is feasible and widely accepted. The laparoscopic approach must offer the same quality of surgical specimen as in open surgery. Short-term outcomes such as bowel function, surgical-site infections, pain and hospital stay are slightly improved with the laparoscopic approach. Laparoscopic resection of rectal cancer is not

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Transanal Endoscopic Microsurgery Versus Conventional Transanal Excision for Patients With Early Rectal Cancer

Abstract: The quality of resection is better with TEMS than with TAE. However, the apparently better oncologic outcomes with TEMS can be partly explained by case selection of lower-risk tumors of the upper rectum.

Cited by 186 publications

References 25 publications

Transanal endoscopic microsurgery: a review

Transanal endoscopic microsurgery: a review

Low rectal cancer: Sphincter preserving techniques-selection of patients, techniques and outcomes

Laparoscopic extraperitoneal rectal cancer surgery: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES)

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