Analysis Of The Treatment Outcome About Transanal Endoscopic Microsurgery For Excision Of Rectal Tumors

Surgical operation is the most important means for the treatment of colorectal cancer. In recent years surgical treatment concepts and technologies have considerable progress, The major progress of colorectal tumor surgical treatment is minimally invasive techniques popularization. The application of local resection for rectal cancer is more widely than before. Transanal endoscopic microsurgery(TEM), as an important role in local resection for rectal cancer, hane more widly used in the surgical operation of rectal cancer patients.Objective:To explore the indication of transanal endoscopic microsurgery for rectal cancer by analyzing the treatment outcome about TEM for rectal tumor.Methods:A retrospective analysis was given to the correlative clinicopathologic data of216cases with rectal cancers treated by TEM between June2006and June2009in Provincial Qian Foshan Hospital of Shan Dong University.Results:In216patients, The recurrence rates among patients with malignant tumors were12.8%. The median diameter of the tumor was2.3cm. The mean distance of the tumors from the anal verge was (8.2±3.2) cm. The tumor invaded (32±18.5)%of the circumference averagely. Benign tumor recurrence was detected in4of165patients (2.4%). The rectal cancer patients group included11cases of pTis stage,20cases of pTl and8cases of pT2. All the lesions were excised by transmural TEM in one piece with no positive resected margins. No perioperative mortality and serious complications occured. The median follow-up was28.5months (range1248months). No recurrence happened in pTis cases. There was significant difference between the local recurrence rates for pTl and pT2cases which was5.0%(1/20) and50.0%(4/8) respectively(P<0.05). The recurrence rate in rectal cancer larger than3cm in diameter (19.0%,4/21) was also significantly higher than that of tumours smaller than3cm in diameter(5.5%,1/18)(P<0.05). Multivariate analysis showed that depth of tumour invasion (T stage) and tumour size were the independent risk factors of tumour recurrence after TEM.Conclusions:Transanal endoscopic microsurgery is a safe and feasible technique for rectal sessile adenoma,Local excision of rectal cancers with pTis,pTl stage or early lesions smaller than3cm in diameter by TEM is safe and effective which deserves further popularization.