Open AccessTHE RESULTS OF 600 TRANSANAL ENDOSCOPIC SURGERIES OF RECTAL ADENOMAS AND ADENOCARCINOMAS
Author(s) -
Е. А. Хомяков,
С. В. Чернышов,
Е. Г. Рыбаков,
О. А. Майновская,
Ю. А. Шелыгин
Publication year - 2019
Publication title -
koloproktologiâ
Language(s) - English
Resource type - Journals
eISSN - 2686-7303
pISSN - 2073-7556
DOI - 10.33878/2073-7556-2019-18-3-20-40
Subject(s) - medicine , adenocarcinoma , adenoma , surgery , colorectal cancer , rectum , complication , cancer
AIM: transanal endomicrosurgery (TEM) is the method of choice for local excision of rectal cancer. The presented series of patients is collected prospectively and is the largest of the published in the Russian medical periodicals. PATIENTS AND METHODS: six-hundred patients [average age ±σ 59.8±9 (31-90) years old; 375/600 (62.5%) – women]with rectal adenomas and adenocarcinomas, who underwent TEM in 2011-2019. RESULTS: the mean size of the removed tumors was 3.4±1.5 cm (0.5-10.0). R0 resection was performed in 571/600 (95.2%) of the cases. The complication rate was 3.6% (22/600). Pathomorphological study of the removed specimens revealed adenoma in 450/600 (75.0%) patients, adenocarcinoma in 150/600 (25.0%) cases. The mean time of observation of patients with adenomas was 38.4±25.1 months, with adenocarcinomas – 33.4±23.8 months. The rate of local recurrence in adenomas was 4.5%. Loco-regional recurrence of adenocarcinoma pT1 after TEM was revealed in 6.8% of patients and 30% of pT2 patients without adjuvant treatment. CONCLUSION: TEM is an effective and safe method of treatment of rectal adenomas. With rectal cancer, a thorough selection of patients is required.