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Local full-thickness excision for sessile adenoma and cT1-2 rectal cancer: long-term oncological outcome

PURPOSE: We analyzed all patients who underwent local transanal surgery at our institution to determine oncological outcomes and perioperative risk. METHODS: In 1997, we developed a prospective protocol for rectal tumors: transanal local full-thickness excision was considered curative in patients wi...

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Autores principales: Gascon, Maria A., Aguilella, Vicente, Martinez, Tomas, Antinolfi, Luigi, Valencia, Javier, Ramírez, Jose M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467953/
https://www.ncbi.nlm.nih.gov/pubmed/35732844
http://dx.doi.org/10.1007/s00423-022-02593-7
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author Gascon, Maria A.
Aguilella, Vicente
Martinez, Tomas
Antinolfi, Luigi
Valencia, Javier
Ramírez, Jose M.
author_facet Gascon, Maria A.
Aguilella, Vicente
Martinez, Tomas
Antinolfi, Luigi
Valencia, Javier
Ramírez, Jose M.
author_sort Gascon, Maria A.
collection PubMed
description PURPOSE: We analyzed all patients who underwent local transanal surgery at our institution to determine oncological outcomes and perioperative risk. METHODS: In 1997, we developed a prospective protocol for rectal tumors: transanal local full-thickness excision was considered curative in patients with benign adenoma and early cancers. In this analysis, 404 patients were included. To analyze survival, only those patients exposed to the risk of dying for at least 5 years were considered for the study. RESULTS: The final pathological analysis revealed that 262 (64.8%) patients had benign lesions, whereas 142 had malignant lesions. Postoperative complications were recorded in 12.6%. At the median time of 21 months, 14% of the adenomas and 12% of cancers had recurred, half of which were surgically resected. The overall 5-year survival rate was 94%. CONCLUSION: With similar outcomes and significantly lower morbidity, we found local surgery to be an adequate alternative to radical surgery in selected cases of early rectal cancer.
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spelling pubmed-94679532022-09-14 Local full-thickness excision for sessile adenoma and cT1-2 rectal cancer: long-term oncological outcome Gascon, Maria A. Aguilella, Vicente Martinez, Tomas Antinolfi, Luigi Valencia, Javier Ramírez, Jose M. Langenbecks Arch Surg Original Article PURPOSE: We analyzed all patients who underwent local transanal surgery at our institution to determine oncological outcomes and perioperative risk. METHODS: In 1997, we developed a prospective protocol for rectal tumors: transanal local full-thickness excision was considered curative in patients with benign adenoma and early cancers. In this analysis, 404 patients were included. To analyze survival, only those patients exposed to the risk of dying for at least 5 years were considered for the study. RESULTS: The final pathological analysis revealed that 262 (64.8%) patients had benign lesions, whereas 142 had malignant lesions. Postoperative complications were recorded in 12.6%. At the median time of 21 months, 14% of the adenomas and 12% of cancers had recurred, half of which were surgically resected. The overall 5-year survival rate was 94%. CONCLUSION: With similar outcomes and significantly lower morbidity, we found local surgery to be an adequate alternative to radical surgery in selected cases of early rectal cancer. Springer Berlin Heidelberg 2022-06-22 2022 /pmc/articles/PMC9467953/ /pubmed/35732844 http://dx.doi.org/10.1007/s00423-022-02593-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Gascon, Maria A.
Aguilella, Vicente
Martinez, Tomas
Antinolfi, Luigi
Valencia, Javier
Ramírez, Jose M.
Local full-thickness excision for sessile adenoma and cT1-2 rectal cancer: long-term oncological outcome
title Local full-thickness excision for sessile adenoma and cT1-2 rectal cancer: long-term oncological outcome
title_full Local full-thickness excision for sessile adenoma and cT1-2 rectal cancer: long-term oncological outcome
title_fullStr Local full-thickness excision for sessile adenoma and cT1-2 rectal cancer: long-term oncological outcome
title_full_unstemmed Local full-thickness excision for sessile adenoma and cT1-2 rectal cancer: long-term oncological outcome
title_short Local full-thickness excision for sessile adenoma and cT1-2 rectal cancer: long-term oncological outcome
title_sort local full-thickness excision for sessile adenoma and ct1-2 rectal cancer: long-term oncological outcome
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467953/
https://www.ncbi.nlm.nih.gov/pubmed/35732844
http://dx.doi.org/10.1007/s00423-022-02593-7
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