Binda Cecilia, Secco Matteo, Tuccillo Luigi, Coluccio Chiara, Liverani Elisa, Jung Carlo Felix Maria, Fabbri Carlo, Gibiino Giulia
Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, 47121 Forlì, Italy.
J Clin Med. 2024 Apr 16;13(8):2292. doi: 10.3390/jcm13082292.
A rise in the incidence of early rectal cancer consequent to bowel-screening programs around the world and an increase in the incidence in young adults has led to a growing interest in organ-sparing treatment options. The rectum, being the most distal portion of the large intestine, is a fertile ground for local excision techniques performed with endoscopic or surgical techniques. Moreover, the advancement in endoscopic optical evaluation and the better definition of imaging techniques allow for a more precise local staging of early rectal cancer. Although the local treatment of early rectal cancer seems promising, in clinical practice, a significant number of patients who could benefit from local excision techniques undergo total mesorectal excision (TME) as the first approach. All relevant prospective clinical trials were identified through a computer-assisted search of the PubMed, EMBASE, and Medline databases until January 2024. This review is dedicated to endoscopic and surgical local excision in the treatment of early rectal cancer and highlights its possible role in current and future clinical practice, taking into account surgical completion techniques and chemoradiotherapy.
世界各地的肠道筛查项目致使早期直肠癌发病率上升，且年轻成年人中的发病率也有所增加，这使得人们对保留器官的治疗方案愈发关注。直肠作为大肠的最远端部分，是采用内镜或手术技术进行局部切除的理想部位。此外，内镜光学评估的进步以及成像技术更精准的定义，使得早期直肠癌的局部分期更加精确。尽管早期直肠癌的局部治疗似乎前景广阔，但在临床实践中，大量本可从局部切除技术中获益的患者却首先接受了全直肠系膜切除术（TME）。通过计算机辅助检索PubMed、EMBASE和Medline数据库，确定了截至2024年1月的所有相关前瞻性临床试验。本综述致力于探讨早期直肠癌治疗中的内镜和手术局部切除，并考虑手术完成技术和放化疗，突出其在当前及未来临床实践中可能发挥的作用。
