Is Local Resection of Anal Canal Tumors Feasible with Transanal Endoscopic Surgery?

Background An important drawback of local surgery for lesions in the anal canal is the difficulty of achieving en bloc full-thickness resections. The aim of this study is to evaluate TEM/TEO in lesions of this type from the point of view of morbidity, mortality and the quality of the pathology speci...

Full description

Saved in:
Bibliographic Details
Published in:World journal of surgery 2020-03, Vol.44 (3), p.939-946
Main Authors: Serra-Aracil, Xavier, Campos-Serra, Andrea, Mora-López, Laura, Serra-Pla, Sheila, Pallisera-Lloveras, Anna, Flores-Clotet, Roser, Zárate-Pinedo, Alba, Navarro-Soto, Salvador
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Aged
Aged, 80 and over
Anal Canal - surgery
Anus
Anus Neoplasms - pathology
Anus Neoplasms - surgery
Biopsy
Canals (anatomy)
Cancer
Cardiac Surgery
Comparative analysis
Complications
Data collection
Endoscopy
Feasibility Studies
Female
General Surgery
Humans
Lesions
Male
Margins of Excision
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Mortality
Original Scientific Report with Video
Pathology
Postoperative Complications - etiology
Rectal Neoplasms - pathology
Rectal Neoplasms - surgery
Rectum
Retrospective Studies
Statistical analysis
Surgery
Surgical techniques
Thoracic Surgery
Transanal Endoscopic Surgery - adverse effects
Tumors
Variables
Vascular Surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background An important drawback of local surgery for lesions in the anal canal is the difficulty of achieving en bloc full-thickness resections. The aim of this study is to evaluate TEM/TEO in lesions of this type from the point of view of morbidity, mortality and the quality of the pathology specimen. Methods This is an observational study with prospective data collection from June 2004 to July 2018. Two groups are defined: group A (rectal tumors with proximal margin between 0 and ≤4 cm from anal verge) and group B (distal margin > 4 cm from anal verge). A technical description is provided; resections and postoperative complications in both groups are compared. Results During the study period, 757 patients underwent TEM/TEO. Finally, 692 patients were included, 192 patients in group A and 500 patients in group B. An en bloc surgical specimen was obtained in 176/192 patients (91.7%), although the defect was completely sutured in 132 (68.8%). In the comparative analysis, group A did not present significantly greater fragmentation of the resected piece [16/192 (8.3%) vs. 36/500 (7.2%), p  = 0.630], although group A was associated with greater involvement of the surgical margin [28/192 (14.6%), 32/500 (6.4%), p  = 0.001] and clinically relevant morbidity [16/192 (8.3%), 20/500 (4%), p  = 0.034]. There was no mortality. Conclusions The use of TEM/TEO to remove lesions originating in the anal canal is feasible. But we have to take into account that there is an increase in complications, technical difficulties and affected margins resection.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-019-05262-x