Long-term follow-up of local rectal cancer surgery by transanal endoscopic microsurgery.
BACKGROUND
In 1997 we launched a prospective program of transanal endoscopic microsurgery (TEM) for the treatment of rectal cancer.


METHODS
Suitability for TEM was based on endorectal ultrasound results, classified as follows: (I) benign tumors; (II) adenocarcinomas uT0 and uT1 with uN0; (III) adenocarcinomas uT2- uN0, low histological grade with intention to cure; and (IV) advanced stage adenocarcinomas with palliative care


RESULTS
Transanal endoscopic microsurgery was performed in 218 patients: 122 adenomas, and 96 adenocarcinomas: group II-72, group III-19, and group IV-5. Follow-up was >24 months (median 59 months) in 61 patients. Nine were lost to follow-up, and so 52 patients were studied: group II-38, group III-11, and group IV-3. The Kaplan-Meier probability of nonrecurrence of adenocarcinoma by group was 93% in tumors in situ (Tis) and T1; and 77.8% in T2. The Kaplan-Meier probability of survival by group was 100% in Tis and T1 and 82% in T2.


CONCLUSIONS
Rates of recurrence and long-term survival in Tis and T1 adenocarcinomas treated with TEM are similar to those in previously published reports using conventional surgery. Further studies are required in T2 adenocarcinomas to determine a definitive strategy.
Serra-Aracil
Xavier
X
Department of General and Digestive Surgery, Corporació Sanitaria Parc Taulí, Parc Taulí s/n, 08208, Sabadell, Barcelona, Spain. jserraa@cauli.cat
Vallverdú
Helena
H
Bombardó-Junca
Jordi
J
Pericay-Pijaume
Carles
C
Urgellés-Bosch
Joan
J
Navarro-Soto
Salvador
S
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D016019:Survival Analysis; D013997:Time Factors