title: Transanal excision of rectal carcinoma.
abstract: Twenty-two men and 16 women with a mean age of 67 years were treated for rectal carcinoma by transanal excision. Patients presented with rectal bleeding (63%), change in bowel habits (11%), rectal pain (4%), or were asymptomatic and discovered on screening proctosigmoidoscopy (22%). The tumors were located from the anal verge to 8 cm proximally and ranged in size from 1 to 4 cm. Pathologic findings included adenocarcinoma (92%), squamous cell carcinoma (4%), and cloacogenic carcinoma (4%). Postoperative hospitalization averaged two days (0 to 29 days). One patient died of a perioperative myocardial infarction for an operative mortality of 3 per cent. Morbidity was 7 per cent and included urinary retention and pneumonia. Postoperative radiation therapy was administered to 11 patients with either undifferentiated tumors or invasion into the muscularis propria. Follow-up in these 38 patients averaged 30 months. One patient died of metastatic carcinoma, and two patients developed local recurrence that was treated successfully by a low anterior resection or abdominoperineal resection. Transanal excision of rectal carcinoma can be performed in properly selected patients with good overall survival and local control.
authors.affiliation: Scott & White Clinic, Temple, Texas, USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Frazee
authors.forename: R
authors.initials: R
authors.lastname: Patel
authors.forename: M
authors.initials: M
authors.lastname: Belew
authors.forename: J W
authors.initials: JW
authors.lastname: Roberts
authors.forename: J C
authors.initials: JC
authors.lastname: Hendricks
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal; D002277:Carcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011014:Pneumonia / Q000209:etiology; D011183:Postoperative Complications; D012002:Rectal Diseases / Q000601:surgery; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012812:Sigmoidoscopy; D015996:Survival Rate; D016055:Urinary Retention / Q000209:etiology