NDLI: Transanal endoscopic surgery in rectal cancer

Content Provider	PubMed Central
Author	Xavier, Serra-aracil Laura, Mora-lopez Alcantara-moral, Manel Caro-tarrago, Aleidis Gomez-diaz, Carlos Javier Salvador, Navarro-soto
Copyright Year	2014
Abstract	Total mesorectal excision (TME) is the standard treatment for rectal cancer, but complications are frequent and rates of morbidity, mortality and genitourinary alterations are high. Transanal endoscopic microsurgery (TEM) allows preservation of the anal sphincters and, via its vision system through a rectoscope, allows access to rectal tumors located as far as 20 cm from the anal verge. The capacity of local surgery to cure rectal cancer depends on the risk of lymph node invasion. This means that correct preoperative staging of the rectal tumor is necessary. Currently, local surgery is indicated for rectal adenomas and adenocarcinomas invading the submucosa, but not beyond (T1). Here we describe the standard technique for TEM, the different types of equipment used, and the technical limitations of this approach. TEM to remove rectal adenoma should be performed in the same way as if the lesion were an adenocarcinoma, due to the high percentage of infiltrating adenocarcinomas in these lesions. In spite of the generally good results with T1, some authors have published surprisingly high recurrence rates; this is due to the existence of two types of lesions, tumors with good and poor prognosis, divided according to histological and surgical factors. The standard treatment for rectal adenocarcinoma T2N0M0 is TME without adjuvant therapy. In this type of adenocarcinoma, local surgery obtains the best results when complete pathological response has been achieved with previous chemoradiotherapy. The results with chemoradiotherapy and TEM are encouraging, but the scientific evidence remains limited at present.
Related Links	http://dx.doi.org/10.3748/wjg.v20.i33.11538
Ending Page	11545
Page Count	8
Starting Page	11538
File Format	PDF
ISSN	10079327
e-ISSN	22192840
Journal	World Journal of Gastroenterology : WJG
Issue Number	33
Volume Number	20
Language	English
Publisher	Baishideng Publishing Group Inc
Publisher Date	2014-01-01
Access Restriction	Open
Rights Holder	Baishideng Publishing Group Inc
Subject Keyword	Gastroenterology Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Gastroenterology

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