Indications and results of local treatment of rectal cancer.

Background: Local therapy of early rectal carcinoma has become an alternative to the classical radical operation which has a higher morbidity and mortality rate.

Methods: Rectal carcinoma was treated by transanal endoscopic microsurgery (TEM) in 113 patients. The indications for the procedure were pT1 low-risk tumour, advanced tumour in high-risk patients, and patients who refused more radical surgery based on oncological guidelines.

Results: Sixty-four patients had pT1, 33 pT2 and 16 pT3 tumours. No patient died as a result of TEM. The rate of complications which needed operative intervention was 7 per cent. So far, two of the patients treated by local resection of pT1 low-risk tumours have had a recurrence. In both cases, a secondary procedure was possible with curative intent.

Conclusion: Patients with pT1 rectal tumours represent a suitable group for local treatment because of the acceptability of the procedure and the low recurrence rate.