[Early Rectal Cancer: Can Transanal Endoscopic Microsurgery (TEM) Become the Standard Treatment?]

Q3 Medicine

Vestnik Rossiiskoi Akademii Meditsinskikh Nauk Pub Date : 2016-01-01 DOI:10.15690/vramn719

Y A Shelygin, S V Chernyshov, O A Mainovskaya, I V Zarodnyuk, L P Orlova, E G Rybakov

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引用次数: 11

Abstract

Aim: Transanal endoscopic microsurgery (TEM) is a main treatment technique for rectal adenomas, but can also be used for selected malignant tumors. This study presents TEM experience.

Methods: The study enrolled patients with rectal adenomas, and selected adenocarcinomas. Preoperative work-up included: digital rectal examination, rectoscopy with biopsy, colonoscopy, EUS, pelvic MRI.

Results: Three hundred and thirty patients [mean age of 61,4±10 (33–88)] underwent TEM. The mean size ± SD of tumors was 3.2±1.2 cm (0.6–10.0). Mean distance from anal verge was 6.7±2.6 cm (2.0–14.0). Preoperative biopsy revealed: adenoma ― 263/330 (79,7%), adenocarcinoma ― 67/330 (20,3%). The median operating time was 40 (15–220) min. Tumor-free margins were obtained in all operative specimens. In 5/330 (1.5%) cases tumors were fragmented. The morbidity rate was 19/330 (5.7%). Pathological investigation revealed: adenoma in 192/330 (58.1%) cases, adenocarcinoma stage Tis, T1, T2 and T3 in 138/330 (41.9%). Median follow-up lasted for 24 (1–57) months. Five patients (2.0%) with adenoma and four patients (5.2%) with adenocarcinoma had local recurrence.

Conclusion: Transanal endoscopic microsurgery for rectal adenomas and selected malignant tumors is associated with low morbidity and low recurrents rates.

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早期直肠癌:经肛门内镜显微手术(TEM)能成为标准治疗方法吗?]

目的:经肛门内镜显微手术(TEM)是直肠腺瘤的主要治疗技术，但也可用于某些恶性肿瘤。本研究呈现TEM经验。方法:研究纳入直肠腺瘤患者，并选择腺癌。术前检查包括:直肠指检、直肠活检、结肠镜检查、EUS、盆腔MRI。结果:接受TEM治疗的患者330例，平均年龄61,4±10(33-88)岁。肿瘤平均大小±SD为3.2±1.2 cm(0.6 ~ 10.0)。平均距肛缘6.7±2.6 cm(2.0 ~ 14.0)。术前活检显示:腺瘤263/330(79.7%)，腺癌67/330(20.3%)。中位手术时间为40 (15-220)min。所有手术标本均获得无瘤边缘。5/330(1.5%)的病例肿瘤呈碎片化。发病率为19/330(5.7%)。病理检查显示:腺瘤192/330例(58.1%)，腺癌分期Tis、T1、T2、T3 138/330例(41.9%)。中位随访时间为24(1-57)个月。腺瘤5例(2.0%)，腺癌4例(5.2%)局部复发。结论:经肛门内镜下显微手术治疗直肠腺瘤及部分恶性肿瘤，发病率低，复发率低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vestnik Rossiiskoi Akademii Meditsinskikh Nauk Medicine-Medicine (all)

CiteScore

1.50

自引率

0.00%

发文量