Ondhia, M, Tamvakeras, P, O'Toole, P, Montazerri, A, Andrews, T, Farrell, C, Ahmed, S, Slawik, S, Ahmed, S and Merseyside Early Rectal Cancer Network, (2019) Transanal endoscopic microsurgery for rectal lesions in a specialist regional early rectal cancer centre: the Mersey experience. Colorectal Disease, 21 (10). pp. 1164-1174. ISSN 1462-8910

Preview

Text Colorectal Disease - 2019 - Ondhia - Transanal endoscopic microsurgery for rectal lesions in a specialist regional early.pdf - Published Version Available under License Creative Commons Attribution. Download (445kB) | Preview

Abstract

Aim Organ-preserving local excision by transanal endoscopic microsurgery (TEM) for early rectal cancer offers significantly lower morbidity as compared to formal rectal cancer resection with acceptable outcomes. This study presents our 6-year experience of TEM for rectal lesions referred to a specialist early rectal cancer centre in the UK. Method Data were collected for all patients referred for TEM of suspected early rectal cancer to a regional specialist early rectal cancer multidisciplinary team (MDT) over a 6-year period. Results One hundred and forty-one patients who underwent full-thickness TEM for suspected or confirmed early rectal cancer were included. Thirty patients were referred for TEM following incomplete endoscopic polypectomy. Final pathology was benign in 77 (54.6%) cases and malignant in 64 (45.4%). Of the 61 confirmed adenocarcinomas, TEM resections were pT0 in 17 (27.9%), pT1 in 32 (51.7%), pT2 in 11 (18.0%) and pT3 in 1 (1.6%). Thirty-eight of 61 patients (62.3%) had one or more poor histological prognostic features and these patients were offered further treatment. Twenty-three of 61 (37.7%) patients with rectal adenocarcinoma required no further treatment following TEM. Forty-three cases of rectal adenocarcinoma were available for establishing recurrence rates. Two of 43 patients (4.7%) developed a recurrence at a median follow-up of 28.7 months (12.1–66.5 months). The overall estimated 5-year overall survival rate was 87.9% and the disease-free survival rate was 82.9%. Conclusion Acceptable outcomes are possible for TEM surgery with appropriate patient selection, effective technique, expert histopathology, appropriate referral for adjuvant treatment and meticulous follow-up. This can be achieved through an early rectal cancer MDT in a dedicated specialist regional centre.

Item Type:	Article
Uncontrolled Keywords:	1103 Clinical Sciences; Surgery
Subjects:	R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) R Medicine > RD Surgery R Medicine > RT Nursing
Divisions:	Nursing & Allied Health
Publisher:	Wiley
SWORD Depositor:	A Symplectic
Date Deposited:	19 Feb 2024 14:36
Last Modified:	19 Feb 2024 14:45
DOI or ID number:	10.1111/codi.14730
URI:	https://researchonline.ljmu.ac.uk/id/eprint/22654

View Item