Gasless, video endoscopic transanal excision for carcinoid and laterally spreading tumors of the rectum.
BACKGROUND
The aim of this study is to determine whether gasless, video endoscopic transanal-rectal tumor excision (gasless VTEM) is a valid treatment for rectal carcinoid and laterally spreading tumors (LST).


METHODS
Eighty-four patients with an adenoma, adenocarcinoma (Tis/T1), or carcinoid tumor of the rectum were divided into three groups: (i) LST ( n = 17 patients), (ii) carcinoid ( n = 11), and (iii) control with other types of tumors ( n = 56).


RESULTS
The LST group had a longer median operating time than in the control group, whereas the carcinoid group had a shorter operating time. Two patients (11.7%) in LST group developed peritoneal entry during the operation, while 2 patients (3.6%) in the control group experienced postoperative complications. During a median follow-up length of 55.2 months, one patient in the LST group developed a recurrence.


CONCLUSIONS
Gasless VTEM is a simple, minimally invasive procedure used to treat LST and carcinoid tumors of the rectum. However, resection for the LST group had a high risk of peritoneal entry during operation.
First Department of Surgery, Nagasaki University School of Medicine, Nagasaki, Japan. nakagoe@net.nagasaki-u.ac.jp
T
T
Nakagoe
H
H
Ishikawa
T
T
Sawai
T
T
Tsuji
M
M
Jibiki
A
A
Nanashima
H
H
Yamaguchi
T
T
Yasutake
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D007432:Intraoperative Period / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D010537:Peritoneum / Q000293:injuries; D011351:Proctoscopy / Q000379:methods*; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012042:Registries; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*