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Local Excision Versus Total Mesorectal Excision for Clinical Stage I (cT1–cT2) Rectal Cancer

  • Surgery and Surgical Innovations in Colorectal Cancer (S Huerta, Section Editor)
  • Published:
Current Colorectal Cancer Reports

Abstract

Early rectal cancer (cT1 and cT2) has been increasingly detected due to the wide application of colorectal cancer screening program. Total mesorectal excision (TME) is a gold standard for the treatment of this early stage disease. However, postoperative complications, unfavorable functional outcomes, and risk of permanent stoma following TME are not uncommon. In contrast, local excision (LE) is less invasive and more tolerable to frail patients and those with severe co-morbidities. Simultaneously, both functional and sexual outcomes following LE were not disturbed and the patient could avoid abdominoperineal resection. The drawback of LE is leaving perirectal lymph node yielding unknown actual pathological nodal staging—which partly leads to more recurrence comparing to TME. This article aimed to review the current evidence of TME and LE in early rectal cancer, to critically review the role and consequence of chemoradiation in LE, and to update ongoing trials on this subject.

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Authors and Affiliations

  1. Colorectal Surgery Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang-Lung Road, Bangkok-Noi, Bangkok, 10700, Thailand

    Woramin Riansuwan & Varut Lohsiriwat

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  1. Woramin Riansuwan
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  2. Varut Lohsiriwat
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Correspondence to Varut Lohsiriwat.

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This article is part of the Topical Collection on Surgery and Surgical Innovations in Colorectal Cancer

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Riansuwan, W., Lohsiriwat, V. Local Excision Versus Total Mesorectal Excision for Clinical Stage I (cT1–cT2) Rectal Cancer. Curr Colorectal Cancer Rep 13, 54–60 (2017). https://doi.org/10.1007/s11888-017-0350-0

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