THE ROLE OF TRANSANAL ENDOSCOPIC MICROSURGERY IN THE TREATMENT OF T1N0 RECTAL CANCER – CASE SERIES AND REVIEW OF THE LITERATURE

1) Clinic of Endoscopic, Endocrine surgery and Coloproctology, Military Medical Academy, Sofia.,

2) Faculty of Public Health, Medical University – Sofia.,

3) Clinic of Abdominal Surgery, Military Medical Academy, Sofia.,

4) Clinic of Radiology, UHAT “St. John Rilski”, Sofia

Disclosure: The author has declared no conflicts of interest.

Received: 19.02.16 Accepted: 26.02.16

Citation: doi:10.5455/ijsm.microsurgery

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Abstract:

Currently, there has been an increasing trend toward transanal endoscopic microsurgery as a definitive treatment of T1 rectal cancer. Despite the promising results from the earlier series, the more recent studies reported a higher rate of local recurrences.
Methods:
A retrospective analysis of 20 patients with T1 rectal cancer managed by transanal endoscopic microsurgery is presented.
Results:
The patients were followed-up for mean 39.3 months. Local recurrences occurred in 5.3% of low-risk, 50% of high-risk T1 cases. The 3-year and 5-year cancer-specific survival in T1 group were 94.4% and 73.5%, respectively with mean time without LR was 81.5 months (90.5 months in the low-risk and 21 months in the high-risk group).
Conclusion:
The results corroborate the excellent prognosis for low-risk T1 cancers treated by TEM alone. For a high-risk T1 cancer adjuvant radiotherapy or conventional resection is highly recommended.

Keywords: early rectal cancer, transanal endoscopic microsurgery, risk factors, adjuvant radiotherapy

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