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Revista Cubana de Cirugía
On-line version ISSN 1561-2945
Abstract
BARRERAS GONZALEZ, Javier Ernesto; HERNANDEZ ASCUY, Marianela; CACERES LAVERNIA, Haslen Hassiul and QUESADA LEMUS, Solvey. Transanal Endoscopic Microsurgery for Treating Rectal Cancer. Rev Cubana Cir [online]. 2023, vol.62, n.3 Epub Sep 01, 2023. ISSN 1561-2945.
Introduction:
Transanal endoscopic microsurgery is a minimally invasive procedure applied for the local treatment of rectal cancer at early stages. Its use in more advanced stages of rectal cancer is controversial. However, with the routine use of neoadjuvant treatment, it is an attractive option that has begun to be considered.
Objective:
To assess the outcomes of transanal endoscopic microsurgery for the treatment of rectal cancer at Centro Nacional de Cirugía de Mínimo Acceso.
Methods:
A retrospective study of an 18-year prospective database was performed. The sample consisted of 150 patients who met the selection criteria and the variables studied were age, sex, indication, surgical time, among others.
Results:
The main indication was T1 rectal adenocarcinoma. The mean age was 63 years (32-93); surgical time, 76 minutes (25-240); and tumor size, 2.8 cm (1-4). Hospital stay was 1 day (12 hours-7 days), morbidity was 6.7 %, and the main postoperative complications were bleeding, suture dehiscence, abscess, rectovaginal fistula and stenosis. Local recurrence was 8.2 %, 7.1 % and 2.5 % for T1, T2 and T3 adenocarcinomas, respectively. Overall survival at 5 years was 97.5 % and disease-free survival was 95.5 %.
Conclusion:
Transanal endoscopic microsurgery is a feasible and safe technique for treating T1 adenocarcinomas, while T2 and T3 adenocarcinomas require preoperative radiochemotherapy.
Keywords : transanal endoscopic microsurgery; rectal cancer; radiochemotherapy.