A. Heintz et al., COMPARISON OF RESULTS AFTER TRANSANAL ENDOSCOPIC MICROSURGERY AND RADICAL RESECTION FOR T1 CARCINOMA OF THE RECTUM, Surgical endoscopy, 12(9), 1998, pp. 1145-1148
Background: We compared the results of transanal endoscopic microsurge
ry and radical surgery in patients with T1 carcinomas of the rectum. M
ethods: We performed a retrospective study (1985-96) to compare the re
sults obtained in 103 patients with T1 rectal carcinomas (low-risk T1,
n = 80; high-risk T1; n = 23) undergoing transanal endoscopic microsu
rgery and radical surgical therapy. Results: The complication rate in
patients undergoing local excision was 3.4% (two of 58); it was 18% (e
ight of 45) in the group treated with radical surgery. Two of 45 patie
nts (3.8%) died after radical resection; there were no deaths after lo
cal excision, With regard to the actuarial 5-year survival rate, no di
fference was observed in the group with low-risk T1 carcinoma between
patients treated with local excision (79%) and those who had radical r
esection (81%) (p = 0.72). Tn patients with high-risk T1 carcinoma, ly
mph node metastases were identified in four of 11 patients undergoing
radical resection (36%), Four of 12 patients with high-risk T1 carcino
ma treated by local excision developed recurrences, whereas none of th
e patients undergoing primary radical surgery had a recurrence. Conclu
sions: Transanal endoscopic microsurgery for the treatment of low-risk
T1 carcinomas is associated with a significantly lower complication r
ate than radical surgical therapy. There is no difference in 5-year su
rvival between local and radical surgical therapy in patients with low
-risk T1 carcinoma.