Transanal endoscopic microsurgical submucosal dissection (TEM-ESD): A novel approach to the local treatment of early rectal cancer

2021 ◽  
pp. 101662
Author(s):  
Konstantinos Kouladouros ◽  
Jörg Baral
Keyword(s):  
Rectal Cancer ◽  
Local Treatment ◽  
Early Rectal Cancer ◽  
Submucosal Dissection ◽  
Novel Approach

scholarly journals SYSTEMATIC REVIEW AND METAANALYSIS OF TRANSANAL ENDOSCOPIC MICROSURGERY VERSUS ENDOSCOPIC SUBMUCOSAL DISSECTION FOR RECTAL ADENOMAS AND EARLY RECTAL CANCER

2019 ◽  
Vol 18 (2) ◽  
pp. 7-20
Author(s):  
S. V. Chernyshov ◽  
M. A. Tarasov ◽  
M. A. Nagudov ◽  
D. A. Mtvralashvili ◽  
A. Likutov ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Rectal Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Transanal Endoscopic Microsurgery ◽  
Meta Analysis ◽  
Early Colorectal Cancer ◽  
Early Rectal Cancer ◽  
Submucosal Dissection ◽  
Endoscopic Microsurgery

AIM: transanal endomicrosurgery (TEM) is the standard for organ-preserving treatment of patients with large adenomas and early rectal cancer. The advantage of TEM in comparison with other transanal methods of treatment of rectal tumors is the low frequency of R1 resections and fragmentation, which procudes a low level of local recurrences. Endoscopic submucosal dissection (ESD) is a new technology for superficial rectum tumors. This systematic review and meta-analysis compared safety and efficacy of ESD vs TEM for large adenoma and early colorectal cancer.PATIENTS AND METHODS: a literature search and meta-analysis of the data was carried out in accordance with the English-language Medline database without restrictions on the publication date (end December 18, 2018) according to keywords: «endoscopic submucosal dissection», «esd», «endoscopic dissection», «tem», «tamis», «transanal endoscopic microsurgery», «transanal resection», «teo», «transanal endoscopic microsurgical excision». The systematic review includes all papers on the comparison of TEM and ESD for large adenomas and early rectal cancer. Statistical data processing was performed using Review Manager 5.3.RESULTS: four retrospective comparative studies were included in the analysis (215 patients). Groups were homogenous in the number of tumors (Odds ratio [OR]=1,19; 95% confidence interval [CI] 0.23-6.16) and size (p=0.55). The intraoperative morbidity included bleeding (p=0.54) and rectal perforation (p=0.32) was homogenous as well. The operation time in the ESD group was significantly longer by 32 minutes than TEM (OR=32.5;95% CI 17,7-47.4; p<0.0001). Postoperative stay was higher than in 1.6 times after TEM (OR=16.1; 95% CI 1.5-30.1; p=0.03). The antibiotics use after surgery was not significantly different in both groups (p=0.33). The en-bloc resections (p=0.66) and the rate of R1 resections (p=0.74) were not significantly different in both groups. The local recurrence rate was homogenous (p=0.95).CONCLUSIONS: the ESD and TEM procedures are safe and effective techniques for local excision of adenomas and early colorectal cancer, but a randomized study is needed to prove the results.

Endoscopic submucosal dissection versus transanal endoscopic microsurgery for the treatment of early rectal cancer

2013 ◽  
Vol 28 (4) ◽  
pp. 1173-1179 ◽  
Author(s):  
Fábio Shiguehissa Kawaguti ◽  
Caio Sérgio Rizkallah Nahas ◽  
Carlos Frederico Sparapan Marques ◽  
Bruno da Costa Martins ◽  
Felipe Alves Retes ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Transanal Endoscopic Microsurgery ◽  
Early Rectal Cancer ◽  
Submucosal Dissection ◽  
Endoscopic Microsurgery

Su1446 Endoscopic Submucosal Dissection (ESD) Versus Transanal Endoscopic Microsurgery (TEM) for the Treatment of Early Rectal Cancer

2012 ◽  
Vol 75 (4) ◽  
pp. AB334-AB335 ◽  
Author(s):  
Fabio S. Kawaguti ◽  
Caio Sergio R. Nahas ◽  
Carlos Frederico S. Marques ◽  
Bruno C. Martins ◽  
Felipe A. Retes ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Transanal Endoscopic Microsurgery ◽  
Early Rectal Cancer ◽  
Submucosal Dissection ◽  
Endoscopic Microsurgery

Long term analysis of recurrences in patients treated by multimodality approach for local treatment of early rectal cancer—Liverpool’s Experience

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18539-18539 ◽  
Author(s):  
A. Sun Myint ◽  
F. Elam ◽  
A. McDonald ◽  
M. J. Hershman
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Salvage Surgery ◽  
Local Treatment ◽  
Early Rectal Cancer ◽  
Radical Radiotherapy ◽  
Mortality And Morbidity ◽  
Multimodality Approach

18539 Background: Local treatment of early rectal cancer with curative intent is highly controversial. Three years ago, we reported our results in 100 patients treated by multimodality approach. We have updated our results and analyse the pattern of recurrences in155 patients treated up to 2005 Methods: From Jan 1992 to Jan 2005, local treatment was offered to 155 patients with low rectal carcinoma. The majority of patients were elderly with the mean age of 76 years( range 33–101). There were 87 males and 68 females. 109 had surgery; TEM (79 patients) and TAR(30 patients). Forty six patients had radical radiotherapy alone.Locally treated patients were followed up regularly with DRE and sigmoidoscopy. CT and MRI scans were done at 0,12 and 24 months. Results: Local recurrence only occured in 13 patients (8.3%). Four patients had local and distant recurrence (2.5%). Overall local recurrence occured in 17 patients (10.8 %). Salvage surgery was carried out in 11 patients(10 APER and 1 local excision). Two had retreatment with Papillon. A total of 13 patients had salvage treatments (76.5%). At median follow-up of 40 months (range 12–168) only 72.7% of patients were still alive. Five patients (3.2%) developed distant metastases only and one had nodal recurrence. Cancer specific survival was 96% and colostomy free survival was 93%. Conclusions: Local treatment of early rectal cancer is a complex issue that needs to be address and discuss. As ageing populationis likely to increased in the next decade demands on local treatment will increase. It is important to balance the benefits of radical surgery in terms of lower local recurrence against increase mortality and morbidity from such procedures especially in elderly patients, versus slightly higher local recurrences and much lower mortality and morbidity from conservative treatments such as TEM and Papillon contact radical radiotherapy. Our study has shown that local treatment is safe and effective treatment for elderly patients with medical co morbidity. In our experience, salvage surgery can be offered for recurrences in the majority of patients but long term close follow-up is necessary. A careful case selection and multimodality treatment is essential for successful out come. No significant financial relationships to disclose.

Novel technique of endoscopic submucosal dissection by using external forceps for early rectal cancer (with videos)

2012 ◽  
Vol 75 (6) ◽  
pp. 1253-1257 ◽  
Author(s):  
Hiroyuki Imaeda ◽  
Naoki Hosoe ◽  
Yosuke Ida ◽  
Hiromasa Nakamizo ◽  
Kazuhiro Kashiwagi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Early Rectal Cancer ◽  
Novel Technique ◽  
Submucosal Dissection
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