Type of publication:
*Vidyasankar V.; *Chakrabarthy A.; *McCloud J.; *Clarke R.
Colorectal Disease; Sep 2019; vol. 21, S3, p. 54
Aim: Randomised controlled trials have demonstrated advantages of Transanal endoscopic microsurgery (TEMS) for early rectal cancer resections. The aim of our study was to assess the safety and outcome of TEMS for early rectal cancer at a U.K district general hospital. Method(s): Between July 2011 to January 2017, 27 patients, 13 men and 14 women, Mean age 77 years, underwent TEMS. Mean lesion diameter was 49 mm. Patient selection was based on multidisciplinary decision. Follow up included colonoscopy, MRI and CT according to standard protocol. Patients were admitted for overnight observation and discharged the following day. Result(s): Mean operative time was 60 minutes. Average hospital stay was 24 hours. One patient (3.7%) had bleeding, three (11%) developed perforation, which were identified and repaired immediately. Two (7.4%) developed pyrexia, One patient (3.7%) developed minor stricture. One (3.7%) developed a recto-vaginal fistula. R0 resection was achieved in 81% and R1 resection was achieved in 19% of cancer cases. One patient (3.7%) developed local recurrence. No mortality. Conclusion(s): Our study demonstrates that TEMS for early rectal cancer can be safely performed in selected patients at a district general hospital, with outcomes comparable with international data.
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