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Transanal Endoscopic Microsurgery vs. Laparoscopic Total Mesorectal Excision for T2N0 Rectal Cancer

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Objective

The aim was to compare transanal endoscopic microsurgery (TEM) and laparoscopic resection (LR) in terms of short-term and oncologic outcomes in patients with a preoperatively diagnosed T2N0 extraperitoneal rectal cancer.

Methods

We conducted a retrospective analysis of a prospective database. All patients with a preoperatively staged T2N0 extraperitoneal rectal adenocarcinoma were considered for LR. Patients refusing LR or medically unfit for LR were considered for TEM, which was associated with neoadjuvant RT in the last cases. Only patients with a minimum follow-up of 36 months were included.

Results

Seventy-eight patients were included. TEM was indicated or preferred in 43 patients; of these, 11 underwent neoadjuvant RT. Morbidity was significantly lower after TEM (p < 0.001). The median follow-up was 70 (36–140) months. A higher local recurrence rate was noted after TEM (26 %), compared to neoadjuvant RT + TEM (0 %) and LR (9 %) (p = 0.070). Overall, 5-year survival rate was 76 % after TEM, 77.8 % after RT + TEM, and 96 % after LR, respectively (p = 0.134).

Conclusions

While TEM alone may only be considered a palliative treatment, it might allow similar oncologic results to abdominal resection in responders to neoadjuvant RT. Large prospective randomized trials are awaited to confirm these findings.

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Authors and Affiliations

  1. Digestive, Colorectal, Oncologic and Minimal Invasive Surgery, University of Torino, Torino, Italy

    Marco Ettore Allaix, Alberto Arezzo, Giuseppe Giraudo & Mario Morino

Authors
  1. Marco Ettore Allaix
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  2. Alberto Arezzo
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  3. Giuseppe Giraudo
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  4. Mario Morino
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Corresponding author

Correspondence to Mario Morino.

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No funds, grants or support was received to complete the study.

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Allaix, M.E., Arezzo, A., Giraudo, G. et al. Transanal Endoscopic Microsurgery vs. Laparoscopic Total Mesorectal Excision for T2N0 Rectal Cancer. J Gastrointest Surg 16, 2280–2287 (2012). https://doi.org/10.1007/s11605-012-2046-8

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