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The outcome of rectal cancer after early salvage surgery following transanal endoscopic microsurgery seems promising.
MedLine Citation:
PMID:  22951201     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Transanal endoscopic microsurgery (TEM) allows locally complete resection of early rectal cancer as an alternative to conventional radical surgery. In patients with unfavourable post-TEM histology, salvage surgery can be performed. The aim of this study was to evaluate the results of early radical surgery after TEM for rectal cancer.
MATERIAL AND METHODS: From 1997 to 2010, 86 TEM procedures were performed in 79 patients due to rectal cancer. Early salvage surgery was performed in 25 patients. Data were obtained from the patients' charts and reviewed retrospectively. Perioperative data and oncological outcome were analysed.
RESULTS: No patients received preoperative chemotherapy. The median time to salvage surgery was 37 days. Five patients underwent laparoscopic surgery. The median operative time was 165 min (range: 101-341 min, 95% confidence interval (CI): 156-214 min) and the median blood loss 275 ml (range: 0-1,275 ml, 95% CI: 232-530 ml). The 30-day mortality was 8% (95% CI: 1-19%, n = 2). Intraoperative perforation occurred in 20% (95% CI: 3-37%, n = 5). The median number of harvested lymph nodes was 12 (range: 3-25, 95% CI: 9-14) and the median circumferential resection margin (CRM) was 10 mm (range: 0-20 mm, 95% CI: 5-12 mm). Only one patient (4%, 95%CI: 1-12%) had a positive CRM. The median follow-up time was 25 months (range: 3-80 months). There was no local recurrence. Distant metastasis occurred in 4% (95% CI: 1-12%, n = 1).
CONCLUSION: Early salvage surgery after TEM seems to be safe despite a high risk of specimen perforation during the operation.
FUNDING: not relevant.
TRIAL REGISTRATION: not relevant.
Authors:
Katarina Levic; Orhan Bulut; Peter Hesselfeldt; Steffen Bülow
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Danish medical journal     Volume:  59     ISSN:  2245-1919     ISO Abbreviation:  Dan Med J     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101576205     Medline TA:  Dan Med J     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  A4507     Citation Subset:  IM    
Affiliation:
Gastroenheden, Kirurgisk Sektion, Hvidovre Hospital, Kettegaard Allé 30, 2650 Hvidovre, Denmark. orhan.bulut@hvh.regionh.dk.
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