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Oncologic Outcomes for Local Excision of Rectal Neoplasia

  • Lawrence LeeEmail author
  • Nathalie Wong-Chong
  • John Monson
Chapter

Abstract

Local excision is a safe alternative to radical resection for benign lesions and early rectal cancer. Technological advances in local excision, such as transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS), have led to improved pathologic specimens with higher negative margin rates and less specimen fragmentation leading to improved oncologic outcomes. In select patients with T1 rectal cancers without adverse features, local excision with curative intent is associated with similar oncologic outcomes compared to TME surgery. Patients with more advanced tumors that refuse TME surgery or are medically unfit can be considered for neoadjuvant chemoradiation followed by local excision with low incidence of local recurrence and comparable disease-free survival as TME.

Keywords

Local excision Transanal endoscopic microsurgery Transanal minimally invasive surgery TAMIS TEO TEM Rectal cancer Oncologic outcomes Rectal adenoma Rectal polyp 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Lawrence Lee
    • 1
    • 2
    Email author
  • Nathalie Wong-Chong
    • 1
  • John Monson
    • 3
    • 4
    • 5
    • 6
  1. 1.Department of SurgeryMcGill University Health CentreMontrealCanada
  2. 2.Center for Outcomes Research and EvaluationMcGill University Health Centre Research InstituteMontrealCanada
  3. 3.Florida Hospital Medical SystemOrlandoUSA
  4. 4.Center for Colon and Rectal SurgeryAdventHealth OrlandoOrlandoUSA
  5. 5.Surgical Health Outcomes Consortium (SHOC)OrlandoUSA
  6. 6.University of Central Florida, College of MedicineOrlandoUSA

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