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Hellenic Journal of Surgery

, Volume 82, Issue 3, pp 161–171 | Cite as

Outcomes of Transanal Endoscopic Microsurgery for T1 and T2 rectal cancer

  • G. SgourakisEmail author
  • S. Lanitis
  • Chr. Kontovounisios
  • V. Armoutidis
  • M. Korontzi
  • C. Zacharioudakis
  • C. Karaliotas
Meta-Analysis
  • 45 Downloads

Abstract

Aim-Background

The objective was to evaluate Transanal Endoscopic Microsurgery as a surgical strategy for stage I rectal cancer and its associated perioperative morbidity and oncologic outcomes.

Methods

The present meta-analysis pooled the effects of outcomes of 986 patients enrolled in 3 randomized controlled trials, 1 prospective and 6 retrospective comparative studies.

Results

The Meta-analysis revealed an advantage to Transanal Endoscopic Microsurgery over Standard Resection in lessening the number of patients presenting with major (O.R= 0,24 (0,07–0,91) and overall postoperative complications (O.R= 0,16 (0,06–0,38) and prolonging the disease-free survival (O.R= 0,46 (0,24–0,88). On the contrary, Standard Resection was superior in terms of the number of patients with positive margins (O.R= 6,49 (1,49–24,91), local recurrence (O.R= 4,92 (1,81–13,41) and overall (local and distant recurrence: O.R= 2,03 (1,15–3,57). No survival advantage was observed in favour of either procedure. The number of patients with positive margins was less in Transanal Endoscopic Microsurgery when compared to Transanal Excision whilst the reverse applied to the disease-free survival.

Conclusions

In selected cases of early rectal cancer Transanal Endoscopic Microsurgery is superior to Standard Resection concerning morbidity and disease- free survival whilst the reverse applies to positive surgical margins, local and overall recurrence. No survival advantage was observed in favour of either procedure. Taking into consideration the comparison of Transanal Endoscopic Microsurgery versus Transanal Excision, Transanal Endoscopic Microsurgery performs better for negative surgical margins, whereas Transanal Excision shows a greater disease-free survival.

Keywords

TEM Transanal endoscopic microsurgery Total mesorectal excision rectal cancer Transanal excision Low anterior resection 

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Copyright information

© Hellenic Surgical Society 2010

Authors and Affiliations

  • G. Sgourakis
    • 1
    Email author
  • S. Lanitis
    • 1
  • Chr. Kontovounisios
    • 1
  • V. Armoutidis
    • 1
  • M. Korontzi
    • 1
  • C. Zacharioudakis
    • 1
  • C. Karaliotas
    • 1
  1. 1.2nd Surgical Department and Surgical Oncology Unit of “Korgialenio — Benakio”Red Cross HospitalAthensGreece

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