Transanal Endoscopic Microsurgery in the Treatment of Rectal Cancer

Eiji Kanehira, Kazunori Hikishima*, Kenji Omura, Tetsuyuki Sunohara, Tadashi Kamesui, Yoh Watanabe

Department of Surgery (I), Kanazawa University
*Department of Surgery, Minamigaoka Hospital

Transanal endoscopic microsurgery (TEM), utilizing an operative rectoscope with a diameter of 40 mm, was performed in 27 rectal cancer cases. The clinical results are presented herein. Our series included 20 early and 7 advanced carcinomas, of which 5 of the latter received TEM as a palliative treatment. Mean tumor diameter was 3.1 cm, maximum 8.5 cm. En bloc resection was successful in 92.6% of the series, while the cut-margin was tumor positive in one advanced case. Mean operative time was 81.7 minutes. There were no complications. Very few patients complained of pain and most began walking on POD 1. Low anterior resection was added in 3 patients, and abdominoperineal rectal amputation in one. During the follow-up period, ranging from 1 month to 3.1 years, no recurrences were noted in the early cancer cases. One palliative case died of a cause unrelated to the cancer and another was found to have a local recurrence. TEM contributes to safe and minimally invasive en bloc resection in early rectal cancer and to palliative treatment for advanced cancer cases.

Key words
1 transanal endoscopic microsurgery, 2 endoluminal rectal surgery, 3 endoscopic treatment for rectal cancer

Reprint requests
Eiji Kanehira Department of Surgery (I), Kanazawa University School of Medicine
13-1, Takaramachi, Kanazawa, 920 JAPAN

Accepted
December 11, 1996

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