Indications and results of local treatment of rectal cancer.
BACKGROUND
Local therapy of early rectal carcinoma has become an alternative to the classical radical operation which has a higher morbidity and mortality rate.


METHODS
Rectal carcinoma was treated by transanal endoscopic microsurgery (TEM) in 113 patients. The indications for the procedure were pT1 low-risk tumour, advanced tumour in high-risk patients, and patients who refused more radical surgery based on oncological guidelines.


RESULTS
Sixty-four patients had pT1, 33 pT2 and 16 pT3 tumours. No patient died as a result of TEM. The rate of complications which needed operative intervention was 7 per cent. So far, two of the patients treated by local resection of pT1 low-risk tumours have had a recurrence. In both cases, a secondary procedure was possible with curative intent.


CONCLUSIONS
Patients with pT1 rectal tumours represent a suitable group for local treatment because of the acceptability of the procedure and the low recurrence rate.
Mentges
B
B
Department of General Surgery of the Eberhard Karls University Hospital, Tübingen, Germany.
Buess
G
G
Effinger
G
G
Manncke
K
K
Becker
H D
HD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005500:Follow-Up Studies; D006801:Humans; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011300:Preoperative Care; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors