Early-Stage Rectal Tumours: Endoscopic Resection or Transanal Surgery?

摘要

With their increasing incidence, the management of early rectal tumors (i.e. adenoma and adenocarcinoma staged usTINO) is paramount. Local excision is the gold standard for Tis and Tlsml, and an attractive option for Tlsm2 lesions, due to a low risk of lymph node invasion (0 to 8%). Transanal microsurgery by TEM (transanal endoscopic microsurgery) and endoscopic submucosal dissection (ESD) are the gold standards for early adenocarcinomas: both are recommended in this indication by the European Association of Endoscopic Surgery (EAES), with similar complete excision rates (TEM 88,5% and ESD 84%, respectively). Only two small one-center studies compared the two procedures without showing any differences. One large national prospective study is ongoing in France.