Effect of transanal excision on rate of recurrence of stage I rectal carcinoma in comparison with radical resection methods
Ambacher, T.; Kasperk, R.; Schumpelick, V.
Der Chirurg; Zeitschrift für Alle Gebiete der Operativen Medizen 70(12): 1469-1474
1999
ISSN/ISBN: 0009-4722 PMID: 10637704 Document Number: 510919
In the case of T1 low-risk rectal cancer, transanal excision is an established method. Now the question arises whether we can also treat higher stages, i.e. T1 high-risk and T2 tumors, by transanal excision with an acceptable recurrence rate. The hospital notes of 152 patients treated by radical resection and transanal excision were examined retrospectively with special regard to the rate of recurrence after an average follow-up of 9.5 years. Twenty-five patients were treated by rectal exstirpation, 105 by anterior resection. In 22 cases local tumor excision was performed: in 12 T1 carcinomas with curative intent and in 10 T2 carcinomas as a minimally invasive procedure for high-risk patients. Recurrence rates were between 8% and 9% in the three different groups. We recommend transanal excision with curative intent only in T1 low-risk tumors. Local excision is seen as an alternative minimally invasive treatment for patients in poor general condition with T2 carcinomas.