caa a22 4500 606248781 CHVBK 20210128101352.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s12262-014-1067-9 doi (NATIONALLICENCE)springer-10.1007/s12262-014-1067-9 Transanal Endoscopic Microsurgery (TEM) for Rectal Cancer: University Hospital of North Tees Experience [Elektronische Daten] [Khalid Osman, Daniel Ryan, Sorena Afshar, Zakir Mohamed, Dharmendra Garg, Talvinder Gill] Transanal endoscopic microsurgery (TEM) is a minimally invasive technique that is increasingly being used to treat early rectal cancer (T1/T2). We studied the outcomes of TEM for rectal cancer at our institution looking at the indication, recurrence rate, need for further radical surgery, 30-day and 12-month mortality and complication rate. We performed a retrospective analysis of prospectively collected data of cases between 2008 and 2012: 110 TEM procedures were performed during this period: 40 were confirmed rectal cancers and 70 were benign. We analysed the data for the 40 patients with confirmed rectal cancer. Thirty (75%) of the subjects were male with a mean age of 71 ± 10years (range 49-90years) and 19 (48%) patients were ASA 3 and 4. Nineteen (48%) of cancers were pT1, eighteen (45%) were pT2, two (5%) were pT3 and one was yPT0. Mean specimen size was 66 ± 20mm (range 33-120mm) with a mean polyp size of 41 ± 24mm (range 18-110mm). The mean cancer size was 24 ± 13mm (range 2-50mm). Average distance from the anal verge was 70 ± 37mm (range 10-150mm), and the mean operating time was 72 ± 22min (range 40-120min), with an average blood loss of 28 ± 15ml (range 10-50ml). Median hospital stay was 2 ± 1days (range 1-7days). Complete excision (R0) was achieved in 37 (93%) patients. Minor post-operative complications included urinary retention in two and pyrexia in three patients. There were no 30-day or 12-month mortalities. Mean follow-up was 13 ± 11months, range (3-40months) Local recurrence occurred in two (5%) patients, both underwent redo TEM. Twelve (30%) patients underwent laparoscopic radical resections (seven AR and five APER) post-TEM. Post-operative histology confirmed pT0N0 in 7/12 patients. Three were lymph node-positive (T0N1), one was pT3N1 and the fifth was pT3N2. TEM is associated with quicker recovery, shorter hospital stay and fewer complications than radical surgery. It is a good alternative to radical surgery in early rectal cancer, especially for high-risk patients. Recurrent tumours can be treated with redo TEM. Association of Surgeons of India, 2014 Transanal endoscopic microsurgery nationallicence Radical surgery nationallicence Rectal cancer nationallicence Local resection nationallicence Osman Khalid Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut Ryan Daniel Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut Afshar Sorena Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut Mohamed Zakir Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut Garg Dharmendra Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut Gill Talvinder Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut Indian Journal of Surgery Springer India 77(2015-12-01), 930-935 0972-2068 77<930 2015 77 12262 https://doi.org/10.1007/s12262-014-1067-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-014-1067-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Osman Khalid Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut NATIONALLICENCE 700 1- Ryan Daniel Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut NATIONALLICENCE 700 1- Afshar Sorena Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut NATIONALLICENCE 700 1- Mohamed Zakir Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut NATIONALLICENCE 700 1- Garg Dharmendra Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut NATIONALLICENCE 700 1- Gill Talvinder Department of Colorectal Surgery, University Hospital of North Tees, Hardwick Road, TS19 8PE, Stockton on Tees, UK aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77(2015-12-01), 930-935 0972-2068 77<930 2015 77 12262