TRANSANAL ENDOSCOPIC MICROSURGERY FOR INVASICE TUMORS HAS SIMILAR LOW COMPICATION RATES WHEN COMPARED TO BENIGN LESIONS RESECTION
Eliahu Y. Bekhor*1,2, Noam Peleg1,2, Nayyera Tibi1,2, Nidal Issa1,2
1Rabin Medical Center, Petah Tikva, Central, Israel; 2Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Tel Aviv, Israel
Background: Transanal-endoscopic-microsurgery (TEM) is a valid technique for rectal adenomas and selected early rectal cancer. The minimal invasiveness nature of the procedure decreases the perioperative and long-term complications and avoids the need for a temporary or permanent stoma. One limitation of this technique lies in its disability to provide histopathologic lymph-node status. Currently, TEM is a valid and preferable option for T1sm1, well-differentiated rectal tumors as well as for benign and pre-malignant lesions. We aimed to assess wheatear patients with malignant tumors – who invades the submucosa, have higher short- and long-term morbidity when compared to non-invasive lesions resection.
Methods: Patients who underwent TEM for benign and malignant rectal cancer at the Division of Surgery, Rabin Medical Center from January 2005 to December 2018 were reviewed retrospectively. Demographics and clinical and pathological data were collected.
Results: We identified a cohort of 198 patients treated by TEM at our department. Out of this cohort, 28 patients were operated on for early-stage rectal cancer (adenocarcinoma group), and 59 patients were operated on for benign lesions (control group).
Demographics were similar in both groups in terms of age, BMI, ASA class, and gender. Both groups had similar lesion-related features (Lesion circumferential location, and heights). The 30-day Clavien–Dindo score, 30-day re-admission rates, and 30-day re-operations rates were similar in both groups. Long-term chronic complications of the procedure were equivocally low for both groups.
Conclusions: TEM is a safe procedure for both patients with invasive rectal cancer and patients with benign lesions.
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