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 26 May 2018

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News

Endoscopic transanal resection for adenomas is safe

Endoscopic transanal resection with urologic resectoscope is oncologically safe for treatment of rectal adenomas, especially where conventional transanal resection is unavailable or unsuitable, finds the latest Diseases of the Colon & Rectum.

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Endoscopic transanal resection is a procedure occasionally conducted for rectal adenomas and other presumably benign lesions.

Dr Jon Tsai and colleagues from Sweden evaluated the efficacy and the safety of endoscopic transanal resection.

The investigative team retrospectively assessed patients who underwent endoscopic transanal resection at 3 Stockholm hospitals between 1993 and 2004.

The team evaluated patient and lesion characteristics, complications, follow-up time, and recurrence rates.

The investigators performed 180 endoscopic transanal resection procedures in 131 patients.

The tissue diagnosis included adenoma in 160 operative cases, and cancer in 12 operative cases.

Hyperplasia, fibrosis, or normal mucosa was diagnosed in the remaining 8 operative cases.

Among the patients with rectal adenomas, 1endoscopic transanal resection was sufficient in 77 cases.

The median follow-up time without recurrence was 32 months
Diseases of the Colon & Rectum

The investigators reported that in 16 cases the surgery was performed in more than 1 session because of the large size of the adenoma.

In 27 cases there were recurrences that needed additional endoscopic transanal resection or other surgery.

The team found that the median time until recurrence was 7 months, but there were no recurrent rectal carcinomas.

In 16 operative cases there were complications.

The investigators noted that 2 patients had to undergo a Hartman's procedure as a result of a bowel perforation.

Only 1 patient had to be reoperated on because of bleeding.

There were no perioperative deaths.

The investigative team observed that the median follow-up time without recurrence was 32 months.

Dr Tsai's team concluded, “Endoscopic transanal resection is a feasible and oncologically safe option for treatment of rectal adenomas.”

“This is especially in cases where conventional transanal resection or transanal endoscopic microsurgery are unavailable or unsuitable because of the characteristics, and localization of the lesion.”

Dis Colon Rectum 2006: 228-32
23 February 2006

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