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• W1887745850 abstract "Background / objectiveTo evaluate the initial experience with transanal endoscopic microsurgery (TEM) for early rectal cancer in a single center.Patients and methodsFrom February 2010 to October 2012 a total of 16 patients underwent TEM for early rectal cancer. 7 were women and 9 men, age range 52 to 88 years (median – 71 years). Postoperative surveillance protocol, which includes rigid proctoscopy, CEA and endorectal ultrasound every 3 months during first two years, was applied to all patients after TEM.ResultsFinal histology revealed 10 (62.5% ) lesions to be T1 and 6 (37.5%) T2 cancers. There were no postoperative complications. All 6 patients in pT2 group and those in pT1 group with unfavorable histology were offered adjuvant chemoradiotherapy or immediate radical surgery. Patients were followed up from 1 to 27 months (median – 14 months). There was one local recurrence (6.25%) in a patient who refused to undergo abdominoperineal excision for T1 low rectal cancer, had unfavorable histology after TEM, for which reason underwent postoperative chemoradiation. The patient had abdominoperineal resection 7 months after TEM (rpT2N0M0). One patient was lost to follow-up. The rest of the patients are alive and disease-free.ConclusionsIn our hands, TEM was an alternative to standard total mesorectal excision in patients with low risk early rectal cancer. Further follow-up is necessary to evaluate recurrence and survival rates after TEM for patients with invasive rectal cancer.Key words: early rectal cancer, transanal endoscopic microsurgery, recurrence, survival.Transanalinė endoskopinė mikrochirurgija anktyvam tiesiosios žarnos vėžiui gydyti Ligoniai ir metodaiNuo 2010 m. vasario iki 2012 m. spalio 16 pacientų, sergančių ankstyvuoju tiesiosios žarnos vėžiu, buvo gydyti TEM būdu (7 vyrai ir 9 moterys, amžius – nuo 52 iki 88 metų; mediana – 71 metai). Visiems pacientams buvo atliekama pooperacinėstebėsena: proktoskopija, endorektalinė sonoskopija ir CEA tyrimas kas 3 mėn. pirmus dvejus metus.RezultataiHistologinio tyrimo metu rasta 10 (62,5 %) T1 navikų ir 6 (37,5 %) T2 navikai. Artimųjų pooperacinių komplikacijų nebuvo. Visiems šešiems pT2 grupės pacientams ir pT1 didelės rizikos pacientams buvo pasiūlyta adjuvantinė chemoradioterapijaar skubus radikalus operacinis gydymas. Pacientai buvo stebimi nuo 1 iki 27 mėn. (mediana –14 mėn.). Vienam pacientui (6,25 %), atsisakiusiam abdominoperinealinės rezekcijos del žemo didelės rizikos T1 naviko, po chemospindulinio gydymonavikas atsinaujino. Po 7 mėn. šiam pacientui buvo atlikta abdominoperinealinė rezekcija (rpT2N0M0). Vienas pacientas pasitikrinti neatvyko. Kiti pacientai yra gyvi, jiems nėra recidyvo.IšvadosTEM yra alternatyvus gydymo metodas tradicinei totalinei mezorektalinei ekscizijai (TME) pacientams, sergantiems mažos rizikos tiesiosios žarnos vėžiu. Tolesnė stebėsena reikalinga siekiant įvertinti recidyvų dažnį ir išgyvenamumą po TEM esantinvazyviam tiesiosios žarnos vėžiui.Reikšminiai žodžiai: ankstyvas tiesiosios žarnos vėžys, gydymas, transanalinė endoskopinė mikrochirurgija." @default.
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• W1887745850 date "2013-01-01" @default.
• W1887745850 modified "2023-09-26" @default.
• W1887745850 title "Transanal endoscopic microsurgery (TEM) for early rectal cancer: single center experience" @default.
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• W1887745850 doi "https://doi.org/10.15388/lietchirur.2013.3.1837" @default.
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