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Is Local Resection of Anal Canal Tumors Feasible with Transanal Endoscopic Surgery? | LitMetric

Is Local Resection of Anal Canal Tumors Feasible with Transanal Endoscopic Surgery?

World J Surg

Coloproctology Unit, General and Digestive Surgery Service, Parc Tauli University Hospital, Sabadell, Universitat Autònoma de Barcelona, Parc Tauli s/n, 08208, Sabadell, Barcelona, Spain.

Published: March 2020

AI Article Synopsis

  • - The study investigates the effectiveness and safety of TEM/TEO surgery for anal canal lesions, focusing on morbidity, mortality, and pathology quality from 2004 to 2018.
  • - A total of 692 patients were analyzed, revealing that the surgery achieved a high rate of en bloc specimen retrieval (91.7%), but group A (closer to the anal verge) showed more surgical margin involvement and complications compared to group B.
  • - Ultimately, while TEM/TEO is deemed feasible for removing anal canal lesions, there is a notable increase in complications and challenges, especially for lesions closer to the anal verge.

Article Abstract

Background: An important drawback of local surgery for lesions in the anal canal is the difficulty of achieving en bloc full-thickness resections. The aim of this study is to evaluate TEM/TEO in lesions of this type from the point of view of morbidity, mortality and the quality of the pathology specimen.

Methods: This is an observational study with prospective data collection from June 2004 to July 2018. Two groups are defined: group A (rectal tumors with proximal margin between 0 and ≤4 cm from anal verge) and group B (distal margin > 4 cm from anal verge). A technical description is provided; resections and postoperative complications in both groups are compared.

Results: During the study period, 757 patients underwent TEM/TEO. Finally, 692 patients were included, 192 patients in group A and 500 patients in group B. An en bloc surgical specimen was obtained in 176/192 patients (91.7%), although the defect was completely sutured in 132 (68.8%). In the comparative analysis, group A did not present significantly greater fragmentation of the resected piece [16/192 (8.3%) vs. 36/500 (7.2%), p = 0.630], although group A was associated with greater involvement of the surgical margin [28/192 (14.6%), 32/500 (6.4%), p = 0.001] and clinically relevant morbidity [16/192 (8.3%), 20/500 (4%), p = 0.034]. There was no mortality.

Conclusions: The use of TEM/TEO to remove lesions originating in the anal canal is feasible. But we have to take into account that there is an increase in complications, technical difficulties and affected margins resection.

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Source
http://dx.doi.org/10.1007/s00268-019-05262-xDOI Listing

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