Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2024; 16(10): 3114-3122
Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3114
Local excision of early rectal cancer: A multi-centre experience of transanal endoscopic microsurgery from the United Kingdom
Ahmed Farid, Matthew Tutton, Prem Thambi, TS Gill, Jim Khan
Ahmed Farid, Department of General Surgery, Oncology Center Mansoura University, Cairo 11432, Egypt
Matthew Tutton, Department of Colorectal Surgery, East Suffolk and North Essex NHS Trust, Colchester CO1 1AA, Essex, United Kingdom
Prem Thambi, Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth PO6 3LY, Hampshire, United Kingdom
TS Gill, Department of Surgery, University Hospital of North Tees, Stockton on Tees TS18-TS21, Darlington, United Kingdom
Jim Khan, Department of General Surgery, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth PO6 3LY, Hampshire, United Kingdom
Author contributions: Khan J, Tutton M, Thambi P, Gill T did the conceptualization, methodology and data collection; Fareed A did the analysis, investigation, and writing; Khan J edited the original draft and revised the manuscript; All authors read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by Portsmouth Hospitals University NHS Trust review board, IRAS No. 293129.
Informed consent statement: Not Applicable as retrospective database review.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: All data used was extracted from a prospective research database and already had ethical approval (IRAS No. 293129). The project was registered with the R&D department at Portsmouth Hospitals University NHS Trust.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jim Khan, FCPS, Professor, Surgical Oncologist, Department of General Surgery, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO6 3LY, Hampshire, United Kingdom. mkhan702@aol.com
Received: June 9, 2024
Revised: July 25, 2024
Accepted: September 3, 2024
Published online: October 27, 2024
Processing time: 110 Days and 10.8 Hours
Core Tip

Core Tip: In this multi-centre study, Trans-anal endoscopic microsurgery was employed in 222 patients of early rectal cancers (T1-T2/early T3, N0), with acceptable oncologic outcomes and morbidity. The main independent factor of survival was the completeness of local excision, while completion total mesorectal excision did not offer a survival benefit. The limitations of this study were the heterogenicity of the data, its retrospective analysis, and the non-comparative design to the total mesorectal excision, which is the standard of care. However, this rectum preservation strategy can be a substitute in selected patients, especially in the evolving era of precision medicine.