Copyright
©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2014; 20(28): 9556-9563
Published online Jul 28, 2014. doi: 10.3748/wjg.v20.i28.9556
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, 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
Revised: April 2, 2014
Accepted: April 27, 2014
Published online: July 28, 2014
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.