Retrospective Study
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World J Gastroenterol. Jul 28, 2014; 20(28): 9556-9563
Published online Jul 28, 2014. doi: 10.3748/wjg.v20.i28.9556
Treatment of rectal cancer by transanal endoscopic microsurgery: Experience with 425 patients
Mario Guerrieri, Rosaria Gesuita, Roberto Ghiselli, Giovanni Lezoche, Andrea Budassi, Maddalena Baldarelli
Mario Guerrieri, Roberto Ghiselli, Giovanni Lezoche, Andrea Budassi, Maddalena Baldarelli, Department of General Surgery, Università Politecnica delle Marche, 60126 Ancona, Italy
Rosaria Gesuita, Interdepartmental “Epidemilogia, Biostatistica e Informatica Medica (EBI)” Centre, Università Politecnica delle Marche, 60126 Ancona, Italy
Author contributions: Guerrieri M and Baldarelli M designated study and wrote article; Gesuita R made statistical analysis; Ghiselli R contributed to drafting the article; Lezoche G and Budassi A performed acquisition of data and follow-up.
Correspondence to: Mario Guerrieri, MD, Department of General Surgery, Università Politecnica delle Marche, Via Conca 71, 60126 Ancona, Italy. guerrieri.m@libero.it
Telephone: +39-71-5963084 Fax: +39-71-5963326
Received: September 27, 2013
Revised: April 2, 2014
Accepted: April 27, 2014
Published online: July 28, 2014
Processing time: 302 Days and 10.3 Hours
Core Tip

Core tip: The gold standard treatment for locally advanced rectal cancer, major surgery, is associated with a high incidence of definitive stoma. In the 1980s, Buess pioneered the removal of rectal lesions with full-thickness excision by transanal endoscopic microsurgery (TEM). It was subsequently demonstrated that T1-N0 lesions can be treated by TEM alone. However, neoadjuvant chemoradiotherapy can downstage T2-T3-N0 lesions and even elicit a complete response. In our experience, the local recurrence and survival rates of selected patients with local-advanced rectal cancer and no nodal involvement treated with neoadjuvant therapy and TEM do not differ significantly from patients treated by major surgery.