Transanal local excision for rectal cancer / 中国普通外科杂志

ABSTRACT

Objective To summarize the experience in transanal local excision (LE) for rectal cancer (RC). Methods The clinical data of 28 cases of RC treated by LE from 1988 to 1998 were analyzed retrospectively. Results In this series, five-year survival rate was 83.4?6.2%, and the local recurrence rate (LRR) was 17.8%. In well-differentiated carcinoma, 4 cases were convinced as local recurrence with a LRR of 17.4%(4/23); in moderately- differentiated carcinoma, one case with a LRR of 20.0%(1/5). The LRR in T 1 and T 2 group was 15.0% (3/20) and 25.0% (2/8) respectively. LRR was 16.7% (4/24) in patients with less than 1/3 bowel wall involved, LRR was 16.7%(4/24),whereas LRR was 25.0%(1/4) in more than 1/3 bowel wall involved group. In total bowel wall resection group the LRR was 16.7%(3/18) while in partial resection group was 20.0% (2/10). In patients with tumour size larger than 4 cm LRR was 22.2% (2/9), tumour size smaller than 4 cm LRR was 15.7% (3/19). Conclusion LE for RC might only be successfully performed in selected patients (T 1～T 2, N 0M 0, well or moderately-differentiated carcinoma,low RC within 6 cm from anal edge). The indications of transanal LE must be controlled strictly. Total excision of tumor and prevention of implantation of carcinoma are the main points in the prophylaxes of recurrence. Postoperative follow-up is needed in order to find local recurrence as early as possible.