Comparison of trans-anal endoscopic operation and trans-anal excision of rectal tumors

Mahdi Hussain Al Bandar, Yoon Dae Han, Syed Asim Razvi, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Namkyu Kim

Research output: Contribution to journalArticle

Abstract

Background Trans-anal endoscopic operation (TEO) has developed to facilitate proper tumor location and ensure excision safely. Methods We reviewed 92 patients enrolled in our database between 2006 and 2014 who were diagnosed with early rectal tumors and who underwent conventional trans-anal excision (TAE) or TEO. Clinical data were collected prospectively to compare safety and feasibility between two techniques. Results Ninety-two patients underwent trans-anal local excision for lower rectal tumors. TEO and TAE were performed in 48 and 44 patients, respectively. Age, sex, and comorbidities were similar. There was no significant difference in tumor diameter (1.6 ± 1.68 cm vs. 1.17 ± 1.17, respectively). Tumor height, however, was higher in the TEO (7.46 ± 3 cm) than the TAE group (3.84 ± 1.88 cm, p < 0.001). Four complications, perianal abscess, and two perforations, occurred in the TEO group, whereas no major complications occurred in the TAE. Seven patients (14.6%) underwent TEO underwent a salvage operation compared to only a single patient in TAE group (2.3%, p = 0.039). Eight patients (17.4%) diagnosed with adenocarcinoma developed recurrence, four in each group. Disease-free survival was similar between groups (TEO – 41.8 months, 95% RI 39.4–44.1; TAE 79.7 months, 95% RI 72.2–87.3). However, more TAE patients (n = 7, 15.9%) than TEO patients (n = 2, 4.2%) underwent chemotherapy. Conclusions TEO treatment of local rectal tumors is safe and feasible and can achieve an adequate resection margin. Local recurrence was similar in both groups. However, the numbers of salvage operations and minor complications were higher in the TEO group.

Original languageEnglish
Pages (from-to)18-24
Number of pages7
JournalAnnals of Medicine and Surgery
Volume14
DOIs
Publication statusPublished - 2017 Feb 1

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Rectal Neoplasms
Recurrence
Neoplasms
Abscess
Disease-Free Survival
Comorbidity
Adenocarcinoma
Databases
Safety
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Al Bandar, Mahdi Hussain ; Han, Yoon Dae ; Razvi, Syed Asim ; Cho, Min Soo ; Hur, Hyuk ; Min, Byung Soh ; Lee, Kang Young ; Kim, Namkyu. / Comparison of trans-anal endoscopic operation and trans-anal excision of rectal tumors. In: Annals of Medicine and Surgery. 2017 ; Vol. 14. pp. 18-24.
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title = "Comparison of trans-anal endoscopic operation and trans-anal excision of rectal tumors",
abstract = "Background Trans-anal endoscopic operation (TEO) has developed to facilitate proper tumor location and ensure excision safely. Methods We reviewed 92 patients enrolled in our database between 2006 and 2014 who were diagnosed with early rectal tumors and who underwent conventional trans-anal excision (TAE) or TEO. Clinical data were collected prospectively to compare safety and feasibility between two techniques. Results Ninety-two patients underwent trans-anal local excision for lower rectal tumors. TEO and TAE were performed in 48 and 44 patients, respectively. Age, sex, and comorbidities were similar. There was no significant difference in tumor diameter (1.6 ± 1.68 cm vs. 1.17 ± 1.17, respectively). Tumor height, however, was higher in the TEO (7.46 ± 3 cm) than the TAE group (3.84 ± 1.88 cm, p < 0.001). Four complications, perianal abscess, and two perforations, occurred in the TEO group, whereas no major complications occurred in the TAE. Seven patients (14.6{\%}) underwent TEO underwent a salvage operation compared to only a single patient in TAE group (2.3{\%}, p = 0.039). Eight patients (17.4{\%}) diagnosed with adenocarcinoma developed recurrence, four in each group. Disease-free survival was similar between groups (TEO – 41.8 months, 95{\%} RI 39.4–44.1; TAE 79.7 months, 95{\%} RI 72.2–87.3). However, more TAE patients (n = 7, 15.9{\%}) than TEO patients (n = 2, 4.2{\%}) underwent chemotherapy. Conclusions TEO treatment of local rectal tumors is safe and feasible and can achieve an adequate resection margin. Local recurrence was similar in both groups. However, the numbers of salvage operations and minor complications were higher in the TEO group.",
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Comparison of trans-anal endoscopic operation and trans-anal excision of rectal tumors. / Al Bandar, Mahdi Hussain; Han, Yoon Dae; Razvi, Syed Asim; Cho, Min Soo; Hur, Hyuk; Min, Byung Soh; Lee, Kang Young; Kim, Namkyu.

In: Annals of Medicine and Surgery, Vol. 14, 01.02.2017, p. 18-24.

Research output: Contribution to journalArticle

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T1 - Comparison of trans-anal endoscopic operation and trans-anal excision of rectal tumors

AU - Al Bandar, Mahdi Hussain

AU - Han, Yoon Dae

AU - Razvi, Syed Asim

AU - Cho, Min Soo

AU - Hur, Hyuk

AU - Min, Byung Soh

AU - Lee, Kang Young

AU - Kim, Namkyu

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background Trans-anal endoscopic operation (TEO) has developed to facilitate proper tumor location and ensure excision safely. Methods We reviewed 92 patients enrolled in our database between 2006 and 2014 who were diagnosed with early rectal tumors and who underwent conventional trans-anal excision (TAE) or TEO. Clinical data were collected prospectively to compare safety and feasibility between two techniques. Results Ninety-two patients underwent trans-anal local excision for lower rectal tumors. TEO and TAE were performed in 48 and 44 patients, respectively. Age, sex, and comorbidities were similar. There was no significant difference in tumor diameter (1.6 ± 1.68 cm vs. 1.17 ± 1.17, respectively). Tumor height, however, was higher in the TEO (7.46 ± 3 cm) than the TAE group (3.84 ± 1.88 cm, p < 0.001). Four complications, perianal abscess, and two perforations, occurred in the TEO group, whereas no major complications occurred in the TAE. Seven patients (14.6%) underwent TEO underwent a salvage operation compared to only a single patient in TAE group (2.3%, p = 0.039). Eight patients (17.4%) diagnosed with adenocarcinoma developed recurrence, four in each group. Disease-free survival was similar between groups (TEO – 41.8 months, 95% RI 39.4–44.1; TAE 79.7 months, 95% RI 72.2–87.3). However, more TAE patients (n = 7, 15.9%) than TEO patients (n = 2, 4.2%) underwent chemotherapy. Conclusions TEO treatment of local rectal tumors is safe and feasible and can achieve an adequate resection margin. Local recurrence was similar in both groups. However, the numbers of salvage operations and minor complications were higher in the TEO group.

AB - Background Trans-anal endoscopic operation (TEO) has developed to facilitate proper tumor location and ensure excision safely. Methods We reviewed 92 patients enrolled in our database between 2006 and 2014 who were diagnosed with early rectal tumors and who underwent conventional trans-anal excision (TAE) or TEO. Clinical data were collected prospectively to compare safety and feasibility between two techniques. Results Ninety-two patients underwent trans-anal local excision for lower rectal tumors. TEO and TAE were performed in 48 and 44 patients, respectively. Age, sex, and comorbidities were similar. There was no significant difference in tumor diameter (1.6 ± 1.68 cm vs. 1.17 ± 1.17, respectively). Tumor height, however, was higher in the TEO (7.46 ± 3 cm) than the TAE group (3.84 ± 1.88 cm, p < 0.001). Four complications, perianal abscess, and two perforations, occurred in the TEO group, whereas no major complications occurred in the TAE. Seven patients (14.6%) underwent TEO underwent a salvage operation compared to only a single patient in TAE group (2.3%, p = 0.039). Eight patients (17.4%) diagnosed with adenocarcinoma developed recurrence, four in each group. Disease-free survival was similar between groups (TEO – 41.8 months, 95% RI 39.4–44.1; TAE 79.7 months, 95% RI 72.2–87.3). However, more TAE patients (n = 7, 15.9%) than TEO patients (n = 2, 4.2%) underwent chemotherapy. Conclusions TEO treatment of local rectal tumors is safe and feasible and can achieve an adequate resection margin. Local recurrence was similar in both groups. However, the numbers of salvage operations and minor complications were higher in the TEO group.

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