Transanal endoscopic surgery in rectal cancer

Total mesorectal excision (TME) is the standard treatment for rectal cancer, but complications are frequent and rates of morbidity, mortality and genitourinary alterations are high. Transanal endoscopic microsurgery (TEM) allows preservation of the anal sphincters and, via its vision system through...

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Detalhes bibliográficos
Autores: Serra-Aracil, X, Mora-Lopez, L, Alcantara-Moral, M, Caro-Tarrago, A, Gomez-Diaz, CJ, Navarro-Soto, S
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2014
País:España
Recursos:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p6359
Acesso em linha:https://i3pt.portalinvestigacion.com/publicaciones/6359
Access Level:acceso abierto
Palavra-chave:Rectal cancer
Rectal adenocarcinoma
Transanal endoscopic microsurgery
Transanal endoscopic surgery
Colorectal cancer
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spelling Transanal endoscopic surgery in rectal cancerSerra-Aracil, XMora-Lopez, LAlcantara-Moral, MCaro-Tarrago, AGomez-Diaz, CJNavarro-Soto, SRectal cancerRectal adenocarcinomaTransanal endoscopic microsurgeryTransanal endoscopic surgeryColorectal cancerTotal mesorectal excision (TME) is the standard treatment for rectal cancer, but complications are frequent and rates of morbidity, mortality and genitourinary alterations are high. Transanal endoscopic microsurgery (TEM) allows preservation of the anal sphincters and, via its vision system through a rectoscope, allows access to rectal tumors located as far as 20 cm from the anal verge. The capacity of local surgery to cure rectal cancer depends on the risk of lymph node invasion. This means that correct preoperative staging of the rectal tumor is necessary. Currently, local surgery is indicated for rectal adenomas and adenocarcinomas invading the submucosa, but not beyond (T1). Here we describe the standard technique for TEM, the different types of equipment used, and the technical limitations of this approach. TEM to remove rectal adenoma should be performed in the same way as if the lesion were an adenocarcinoma, due to the high percentage of infiltrating adenocarcinomas in these lesions. In spite of the generally good results with T1, some authors have published surprisingly high recurrence rates; this is due to the existence of two types of lesions, tumors with good and poor prognosis, divided according to histological and surgical factors. The standard treatment for rectal adenocarcinoma T2N0M0 is TME without adjuvant therapy. In this type of adenocarcinoma, local surgery obtains the best results when complete pathological response has been achieved with previous chemoradiotherapy. The results with chemoradiotherapy and TEM are encouraging, but the scientific evidence remains limited at present. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.BAISHIDENG PUBLISHING GROUP INC2014info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/6359WORLD JOURNAL OF GASTROENTEROLOGYISSN: 10079327ISSNe: 22192840reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p63592026-06-21T15:30:37Z
dc.title.none.fl_str_mv Transanal endoscopic surgery in rectal cancer
title Transanal endoscopic surgery in rectal cancer
spellingShingle Transanal endoscopic surgery in rectal cancer
Serra-Aracil, X
Rectal cancer
Rectal adenocarcinoma
Transanal endoscopic microsurgery
Transanal endoscopic surgery
Colorectal cancer
title_short Transanal endoscopic surgery in rectal cancer
title_full Transanal endoscopic surgery in rectal cancer
title_fullStr Transanal endoscopic surgery in rectal cancer
title_full_unstemmed Transanal endoscopic surgery in rectal cancer
title_sort Transanal endoscopic surgery in rectal cancer
dc.creator.none.fl_str_mv Serra-Aracil, X
Mora-Lopez, L
Alcantara-Moral, M
Caro-Tarrago, A
Gomez-Diaz, CJ
Navarro-Soto, S
author Serra-Aracil, X
author_facet Serra-Aracil, X
Mora-Lopez, L
Alcantara-Moral, M
Caro-Tarrago, A
Gomez-Diaz, CJ
Navarro-Soto, S
author_role author
author2 Mora-Lopez, L
Alcantara-Moral, M
Caro-Tarrago, A
Gomez-Diaz, CJ
Navarro-Soto, S
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Rectal cancer
Rectal adenocarcinoma
Transanal endoscopic microsurgery
Transanal endoscopic surgery
Colorectal cancer
topic Rectal cancer
Rectal adenocarcinoma
Transanal endoscopic microsurgery
Transanal endoscopic surgery
Colorectal cancer
description Total mesorectal excision (TME) is the standard treatment for rectal cancer, but complications are frequent and rates of morbidity, mortality and genitourinary alterations are high. Transanal endoscopic microsurgery (TEM) allows preservation of the anal sphincters and, via its vision system through a rectoscope, allows access to rectal tumors located as far as 20 cm from the anal verge. The capacity of local surgery to cure rectal cancer depends on the risk of lymph node invasion. This means that correct preoperative staging of the rectal tumor is necessary. Currently, local surgery is indicated for rectal adenomas and adenocarcinomas invading the submucosa, but not beyond (T1). Here we describe the standard technique for TEM, the different types of equipment used, and the technical limitations of this approach. TEM to remove rectal adenoma should be performed in the same way as if the lesion were an adenocarcinoma, due to the high percentage of infiltrating adenocarcinomas in these lesions. In spite of the generally good results with T1, some authors have published surprisingly high recurrence rates; this is due to the existence of two types of lesions, tumors with good and poor prognosis, divided according to histological and surgical factors. The standard treatment for rectal adenocarcinoma T2N0M0 is TME without adjuvant therapy. In this type of adenocarcinoma, local surgery obtains the best results when complete pathological response has been achieved with previous chemoradiotherapy. The results with chemoradiotherapy and TEM are encouraging, but the scientific evidence remains limited at present. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
publishDate 2014
dc.date.none.fl_str_mv 2014
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/6359
url https://i3pt.portalinvestigacion.com/publicaciones/6359
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BAISHIDENG PUBLISHING GROUP INC
publisher.none.fl_str_mv BAISHIDENG PUBLISHING GROUP INC
dc.source.none.fl_str_mv WORLD JOURNAL OF GASTROENTEROLOGY
ISSN: 10079327
ISSNe: 22192840
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
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repository.mail.fl_str_mv
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