Transanal Endoscopic Microsurgery with or without Completion Total Mesorectal Excision for T2 and T3 Rectal Carcinoma Article Swipe
Jeroen W. A. Leijtens
,
T. W. A. Koedam
,
Wernard A. A. Borstlap
,
Monique Maas
,
Pascal G. Doornebosch
,
Tom M. Karsten
,
E. Derksen
,
Laurents P. S. Stassen
,
Camiel Rosman
,
Eelco J. R. de Graaf
,
André J. A. Bremers
,
Jeroen Heemskerk
,
Geerard L. Beets
,
Jurriaan B. Tuynman
,
Kevin Rademakers
·
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1159/000486555
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1159/000486555
Aim: Transanal endoscopic microsurgery (TEM) is used for the resection of large rectal adenomas and well or moderately differentiated T1 carcinomas. Due to difficulty in preoperative staging, final pathology may reveal a carcinoma not suitable for TEM. Although completion total mesorectal excision is considered standard of care in T2 or more invasive carcinomas, this completion surgery is not always performed. The purpose of this article is to evaluate the outcome of patients after TEM-only, when completion surgery would be indicated. Methods: In this retrospective multicenter, observational cohort study, outcome after TEM-only (n = 41) and completion surgery (n = 40) following TEM for a pT2–3 rectal adenocarcinoma was compared. Results: Median follow-up was 29 months for the TEM-only group and 31 months for the completion surgery group. Local recurrence rate was 35 and 11% for the TEM-only and completion surgery groups respectively. Distant metastasis occurred in 16% of the patients in both groups. The 3-year overall survival was 63% in the TEM-only group and 91% in the completion surgery group respectively. Three-year disease-specific survival was 91 versus 93% respectively. Conclusions: Although local recurrence after TEM-only for pT2–3 rectal cancer is worse compared to the recurrence that occurs after completion surgery, disease-specific survival is comparable between both groups. The lower unadjusted overall survival in the TEM-only group indicates that TEM-only may be a valid alternative in older and frail patients, especially when high morbidity of completion surgery is taken into consideration. Nevertheless, completion surgery should always be advised when curation is intended.
Related Topics
Concepts
Medicine
Total mesorectal excision
Microsurgery
Rectal carcinoma
Surgery
Carcinoma
Colorectal cancer
General surgery
Cancer
Internal medicine
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1159/000486555
- https://www.karger.com/Article/Pdf/486555
- OA Status
- hybrid
- Cited By
- 14
- References
- 25
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2804879173
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W2804879173Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1159/000486555Digital Object Identifier
- Title
-
Transanal Endoscopic Microsurgery with or without Completion Total Mesorectal Excision for T2 and T3 Rectal CarcinomaWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2018Year of publication
- Publication date
-
2018-05-23Full publication date if available
- Authors
-
Jeroen W. A. Leijtens, T. W. A. Koedam, Wernard A. A. Borstlap, Monique Maas, Pascal G. Doornebosch, Tom M. Karsten, E. Derksen, Laurents P. S. Stassen, Camiel Rosman, Eelco J. R. de Graaf, André J. A. Bremers, Jeroen Heemskerk, Geerard L. Beets, Jurriaan B. Tuynman, Kevin RademakersList of authors in order
- Landing page
-
https://doi.org/10.1159/000486555Publisher landing page
- PDF URL
-
https://www.karger.com/Article/Pdf/486555Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
-
https://www.karger.com/Article/Pdf/486555Direct OA link when available
- Concepts
-
Medicine, Total mesorectal excision, Microsurgery, Rectal carcinoma, Surgery, Carcinoma, Colorectal cancer, General surgery, Cancer, Internal medicineTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
14Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 2, 2024: 1, 2023: 1, 2022: 1, 2021: 1Per-year citation counts (last 5 years)
- References (count)
-
25Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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