Transanal local wide excision for rectal adenocarcinoma.
OBJECTIVE
Abdominoperineal resection is associated with high morbidity and mortality, and sphincter preservation is the aim for the patient. Transanal local wide excision of highly selected rectal cancers is an acceptable alternative to radical surgery.


METHODS
This retrospective study of 18 patients with rectal cancer treated with transanal local wide excision at our hospital during a 6-year period (from 1995 to 2001) is discussed.


RESULTS
Tumor size ranged from 1 to 6 cm (mean, 2.23 cm). All resection margins were free of tumors. There was no surgical mortality or morbidity. Median follow-up period was 17.9 months. Among 18 patients, 12 patients received radiotherapy and chemoradiotherapy as a postoperative adjuvant treatment. There was one local recurrence with liver metastasis noted within one year after the operation. The 1-yr, 2-yr and 5-yr disease-free survival rate was 92%.


CONCLUSIONS
Transanal local wide excision for rectal cancer, when combined with selected chemotherapy or radiotherapy, results in good local-regional control in our series. A Good long-term survival rate was also proven by presented articles. This approach can be safely applied to more advanced tumors (T3 lesion) under accurate pre-op staging, aggressive postoperative adjuvant therapy and careful regular follow-up.
Chen
Chien-Chih
CC
Division of Colorectal Surgery, Department of Surgery, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
Leu
Shuh-Yan
SY
Liu
Mei-Ching
MC
Jian
James Jer-Min
JJ
Chen
Chii-Ming
CM
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal; D017024:Chemotherapy, Adjuvant; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011182:Postoperative Care; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome