Department of Surgery, "Lozano Blesa" University Hospital, San Juan Bosco 15, 50009, Saragossa, Spain.
Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Domingo Miral s/n 50009-Saragossa, Spain.
Langenbecks Arch Surg. 2022 Sep;407(6):2431-2439. doi: 10.1007/s00423-022-02593-7. Epub 2022 Jun 22.
We analyzed all patients who underwent local transanal surgery at our institution to determine oncological outcomes and perioperative risk.
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.
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%.
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.
我们分析了在我院接受局部经肛门手术的所有患者，以确定肿瘤学结果和围手术期风险。
1997 年，我们制定了直肠肿瘤的前瞻性方案：对于良性腺瘤和早期癌症患者，经肛门局部全层切除术被认为是治愈性的。在本分析中，纳入了 404 例患者。为了分析生存情况，仅考虑了至少有 5 年死亡风险的患者。
最终的病理分析显示 262 例（64.8%）患者为良性病变，而 142 例为恶性病变。术后并发症发生率为 12.6%。在 21 个月的中位时间内，14%的腺瘤和 12%的癌症复发，其中一半经手术切除。总的 5 年生存率为 94%。
我们发现，对于早期直肠癌的某些特定病例，局部手术与根治性手术相比具有相似的结果和显著更低的发病率，是一种充分的替代选择。
