Local Excision Of Rectal Tumours

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Transanal Endoscopic Microsurgery (TEM)

Local excision alone does not offer the opportunity for lymph node biopsy and therefore has been reserved for patients in whom the likelihood of cancerous extension is small, local excision can occur under direct visualization in rectal tumors within 10 cm of the anal verge. TEMS extends local excision ability to the proximal rectosigmoid junction.

A Training Programme for Operating Theatre Personnel in

transanal endoscopic operation procedures for local excision of rectal tumours Continued Storz identified that this was not just an CLINICAL FEATURE June 2015 / Volume 25 / Issue 6 / ISBN 1750

Local excision in mid-to-low rectal cancer patients who

local excision (LE) or watchful wait can alternatively be used for patients who respond well to pre-CRT. High- resolution rectal magnetic resonance imaging (MRI) is one of the most useful methods to assess pre-CRT response,

Protocol for the Examination of Specimens From Patients With

Local excision (transanal disk excision) Primary resection specimen with no residual cancer (eg, following neoadjuvant therapy) Cytologic specimens The following tumor types should NOT be reported using this protocol: Tumor Type Well-differentiated neuroendocrine tumors (consider the Colorectal NET protocol)

Transanal surgery for rectal tumors: What is the role?

Local excision for rectal cancer is appropriate in select patients Preoperative tumor assessment can help identify factors associated with increased risk of recurrence Neoadjuvant therapy in conjunction with local excision can result in acceptable oncologic outcomes in patients who are poor candidates for anterior resection

Endoscopic submucosal dissection versus transanal local

ments such as local excision and radical surgery, especially for tumors that are >1 to ≤2 cm in diameter. It appears that small rectal carcinoids <1 cm in size can be safely managed by local excision. For tumors >1 to ≤2cm,local excision is usually recommended, but radical surgery should be considered if there is evidence of lymph node

1250 Review Article (Current Status of Colorectal Cancer

tumours with favourable histology are considered for local excision alone (6). In order to improve the oncological outcomes of local excision, the Cancer and Leukemia Group B (CALGB) conducted a prospective study looking at patients with T1 and T2 distal rectal cancer treated with local excision, where only T2 tumours received adjuvant chemo-RT.

Transanal Surgery for benign tumor or early rectal cancer

excision (TAE) is the most common technique, with excellent results in terms of morbidity but also recurrence rate, knows as Parks procedure (1). Technical advances have made it possible to develop new devices that facilitate surgery and that allow local excision for larger tumors and more difficult to access. For example, transanal endoscopic

Transanal approach for rectal tumors: recent updates and

Local excision of rectal tumors has long been performed. The transsphincteric and transcoccygeal approaches had been used for local excision, especially for high-lying rectal tumors. The transcoccygeal (Kraske) approach requires mobilization of posterior pelvic floor muscles away from the coccyx to expose the rectum and the transsphincteric

Local excision vs. radical surgery in treating rectal nets

Local excision (LE) is performed for rectal neuroendocrine tumors (NETs) <1 cm in size, whereas radical surgery (RS) is performed for larger tumors. The lack of data and limited number of studies support such approaches.

Treatment of early rectal tumours by transanal endoscopic

situ carcinoma, excision is already a cure, but for more ad-vanced staging, further surgery or adjuvant therapy will be required because of possible metastasis to a lymph node. Buess et al1 developed a new procedure for the local resection of rectal tumours, which produces a complete specimen with good margins that can be mounted on a

Predictors of Metastases in Rectal Neuroendocrine Tumors

Coyriht The American Society of Colon Rectal Sureons Inc. Unauthoried reroduction of this article is rohiited. 1372 DISEASES OF THE COLON & RECTUM VOLUME 61: 12 (2018) BACKGROUND: Rectal neuroendocrine tumors are often found incidentally. Local excision alone has been advocated for lesions ≤2 cm; however, the evidence base

Organ preservation in rectal cancer: have all questions been

Local excision is increasingly used instead of total mesorectal excision in early rectal cancers (fi gure 1). Findings from two studies13,14 showed good outcomes in selected T1 tumours, but not in high-risk T1 or T2 3 tumours. Although diff erent techniques are used for local excision (varying from a simple mucosectomy to an

Transanal Endoscopic Microsurgery (TEMS)

Transanal endoscopic microsurgery (TEMS) is a minimally invasive surgical approach to local excision of rectal tumors. It has been used in benign conditions such as large rectal polyps (that cannot be removed through a colonoscope), retrorectal masses, rectal strictures, rectal fistulae,

When is local excision appropriate for early rectal cancer?

rence and a poorer prognosis after local excision compared with radical resection, its use and indications have recently become highly debated issues [4 11]. The key to poten-tially curative local treatment for rectal cancer is to select a suitable patient or tumor for local excision and to choose the most suitable local excision procedure

COLOR III: a multicentre randomised clinical trial comparing

Exclusion criteria are T1 tumours which can be treated by local excision, T3 tumours with margins 1 mm to the endopelvic fascia, tumours with ingrowth in the internal sphincter or m. levator ani and all T4 tumours as staged through MRI scan prior to neoadjuvant therapy. Other causes for exclusion are previous rectal surgery, pregnancy,

Colon and Rectum

Low-grade neuroendocrine tumors (carcinoid tumors) are not included. Based on AJCC/UICC TNM, 7th edition Protocol web posting date: January 2016 Procedures Excisional Biopsy (Polypectomy) Local Excision (Transanal Disk Excision) Colectomy (Total, Partial, or Segmental Resection)

Research Paper Local surgical excision versus endoscopic

Conclusions: For rectal carcinoids sized 20mm or smaller without adverse features, endoscopic resection might be an efficient treatment, which achieved a comparable oncological safety as local surgical excision. Key words: rectal carcinoids sized 20mm or smaller without adverse features; local surgical excision;

Transanal minimally invasive surgery for rectal cancer

local excision of early rectal cancers in certain patients. 4,5 Currently, local excision is only suitable as a curative procedure in early tumors with a low risk of lymph node metastases as local lymph nodes are not adequately addressed with this technique. The surgical platforms for local excision or rectal tumors include

Advances in the treatment of locally advanced rectal cancer

tients with T3 rectal tumors within 12 cm from the anal verge, re-gardless of nodal status. The two groups of patients did not differ significantly in overall survival, local-recurrence-free survival, or distant-recurrence-free survival, but SCRT patients had a somewhat higher rate of local recurrence (7.5% vs 4.4%). This trend may have

Local Excision of Rectal Cancer - CBC

Local excision avoids the morbidity of radical surgery for rectal cancer, but for advanced tumors it is associated with a higher risk of local and distant tumor recurrence. Newer techniques, such as TEM and TAMIS, improve visualization and versatility, and may have superior oncologic outcomes to conventional local excision

Original Article Treatment of Advanced Rectal Cancers

For low lying advanced rectal tumours, the main strategy to attain local control and prolong survival is by multimodality treatment. Before commencing treatment, accurate imaging of the disease for staging is very important. MRI (CT scans) is the method of choice for the local staging of T3/4 tumours. 10 Endorectal ultrasound is good for T1/2

Local Excision in Rectal Cancer

ACR Appropriateness Criteria® 2 Local Excision in Rectal Cancer Surgical Techniques There are 3 operative approaches for LE of a distal rectal lesion: transanal, posterior trans-sphincteric (York-Mason procedure), or posterior proctotomy (Kraske procedure). Transanal excision is the most commonly used approach.

A critical review of the role of local excision in the

sufficiently staged by local excision alone. Despite lingering concerns about the adequacy of a transanal excision, a paradoxical increase in the use of local excision for T1 tumors occurred in the United States between 1989-2003 (9). Subsequently, several authors have cautioned against local


Background Local excision is an organ-preserving treatment alternative for patients with stage I rectal cancer. However, local excision alone is associated with a high risk of local recurrence and

CoC Operative Standard 5.7: Total Mesorectal Excision

Dec 07, 2020 Wide local excision. mid to low rectal tumors 2) Impact of the introduction and training of total mesorectal excision on recurrence and survival in rectal

Selective Approach for Upper Rectal Cancer Treatment: Total

rectal tumors underwent partial mesorectal excision, and only 10 patients (5.6%) of that group received preoperative chemoradiation. t he 5-year actuarial local recurrence, disease-free survival, and cancer-specific survival rates for upper rectal tumors were 4.9%, 82.0%, and 91.6%. local recurrence rates showed no differences

Management of early rectal cancer: Current practice and future

Local Excision (LE) Local excision can be defined as organ-preserving strategy which involves minimal dissection of the early rectal cancer with good resection margins. Rectal dissection can be carried out in sub-mucosal fashion for benign lesions and full thickness for neoplastic or malignant lesions.

Postoperative morbidity and recurrence after local excision

accessible for transanal excision because of the distance from the anal verge, and the recurrence rate after transanal excision of rectal adenomas is 30% in some reports [13]. The alternatives for local treatment of tumours in the middle and upper part of the rectum are trans-sphincteric (Mason) or trans-sacral (Kraske) proce-dures.

The Influence of Histopathologic Criteria on the Long-Term

From 1984 to 2001, 561 patients underwent local excision of rectal tumors at the Clinic of General and Reprints are not available. Correspondence to: Theodor Junginger, M.D., Clinic of General and Abdominal Surgery, Johannes Gutenberg University Hospital, Langenbeckstr. 1, Mainz D-55131, Germany, e-mail: [email protected] ach.klinik.uni-mainz.de

Macroscopic Assessment of Mesorectal Excision in Rectal Cancer

was introduced at the study center, the proportion of rectal excision specimens formally evaluated has increased (Fig.3).Inthefirststudyperiod(1998-1999),only55%of all mesorectal excision specimens were examined, whereas this proportion increased to 88% and 99% in the 2004-2005and2006-2007timeperiods,respectively. Descriptive Characteristics

Transsacral excision with pre‑operative imatinib mesylate

Local excision of anorectal tumors includes the use of transrectal, transsacral and transvaginal approaches-6). (4 However, less invasive approaches for the local resection of rectal GISTs are often inadequate due to the size of the mass and its exophytic growth. In total, 80-95% of GISTs typically express cluster of

Protocol for the Examination of Specimens from Patients with

Local Excision (Transanal Disk Excision) Colectomy (Total, Partial, or Segmental Resection) Rectal Resection Authors Kay Washington, MD, PhD, FCAP* Department of Pathology, Vanderbilt University Medical Center, Nashville, TN Laura H. Tang, MD, PhD, FCAP† Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY

200 Transanal Endoscopic Microsurgery

TEMS extends local excision ability to the proximal rectosigmoid junction. Adenomas, small carcinoid tumors, and nonmalignant conditions (eg, strictures, abscesses) are amenable to local excision by either method. The use of local excision in rectal adenocarcinoma is an area of much interest and may be most

Local Excision in Rectal Cancer - acsearch.acr.org

cancer: implications for local excision surgical strategies. Ann Surg Oncol. 2011;18(13):3686-3693. Observational-Tx 139 patients To analyze long-term outcome of cT3 rectal cancer treated by neoadjuvant chemoradiation therapy in relation to complete pathologic response and type of surgery. Tumors of 42 patients (30.2%) were classified

a s t r o Dige Journal of Gastrointestinal & Digestive sti f

Allison SI, Adedeji A, Varma JS (2001) Per anal excision of large rectal adenomas using an endoscopic stapler. J R Coll Surg Edinb 46: 290-291. 13. De Gennaro VA, Lescher TC (1995) Transanal excision of rectal tumors using a laparoscopic stapler. Dis Colon Rectum 38: 327-328. 14. Miskowiak J, Lindenberg S (1986) Excision of rectal villous adenoma

Restaging Locally Advanced Rectal Cancer with MR Imaging

May 04, 2018 local excision in patients in whom (a) CRT has led to downstaging of tumors to lesions confined to the rectal wall, and (b) there are no longer any involved lymph nodes (17,18). Furthermore, transanal endoscopic microsurgery has been adopted in patients who otherwise would have un-dergone abdominoperineal resection (19). Thus,

Rectal carcinoid tumor: diagnosis and management

which are eligible for local excision, are probably rel-atively benign carcinoids, which would be graded as 1 or 2 in the WHO classification. Small tumors with adverse findings or large and aggressive tumors that may present with pain receive the highest grade among neuroendocrine tumors and thus require more aggressive treatment.8 Rectal

Local recurrence rates associated with completion TME

(95 per cent c.i. 4⋅8to9⋅3) per cent. There were no local recurrences of low-risk pT1 tumours after cTME or aCRT. The local recurrence rate for high-risk pT1 tumours was 13⋅6(8⋅0to22⋅0) per cent for local excision only, 4⋅1(1⋅7to9⋅4) per cent for cTME and 3⋅9(2⋅0to7⋅5) per cent for aCRT. Local