Local resection for rectal tumors: Comparative study of transanal endoscopic microsurgery vs. conventional transanal excision the experience in China

摘要

Background/Aims: To compare the operative range, safety and therapeutic effect of local resection of rectal tumors by using transanal endoscopic microsurgery and conventional transanal excision. Methodology: We reviewed data from 76 patients treated using conventional TAE during the period from January 2003 to July 2006 and 53 patients treated using TEM during the period from September 2006 to February 2010 in the Ruijin Hospital affiliated with the Shanghai Jiaotong University School of Medicine. Results: Age, gender, tumor size, blood loss and postoperative hospital stay were similar in the 2 groups. The median distance from the anal verge was significantly higher in the TEM group than in the TAE group. Operation time was significantly longer in the TEM group than in the TAE group. During the median follow-up of 40 months, the LRR in the TEM group was lower than that in the TAE group, especially for tumors that are larger (>3cm) and located higher (>8cm from the anal verge) and pT1 carcinomas. Conclusions: TEM is a safe, effective and minimally invasive surgical technique for the treatment of early rectal neoplasms. Compared to conventional TAE, TEM has a broader operative range and a better therapeutic effect.