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01.10.2015 | Original Article | Ausgabe 5/2015

European Surgery 5/2015

Transanal endoscopic microsurgery in treatment of small rectal T1 high-risk, T2 and T3 carcinomas combined with radiochemotherapy

European Surgery > Ausgabe 5/2015
MD M. Amann, MD J. Burghardt, MD C. Stratz, MD, PhD G. F. Buess, DMD, MD A. Modabber



The present survey evaluates the value of TEM in the treatment of small T1 high-risk, T2 and T3 carcinomas in combination with neoadjuvant or adjuvant therapy or without radiochemotherapy.


In this retrospective survey, patient data from 86 patients suffering from T1 high-risk, T2 or T3 carcinoma was reviewed.


Overall, Patients with T1 high-risk carcinoma showed a recurrence rate of 12.5 % (n = 16). The recurrence rate of T2 low-risk carcinomas was 11.1 % (n = 36), and of T2 high-risk carcinomas was 31.3 % (n = 17). Patients who had suffered a T3 low-risk carcinoma showed a recurrence rate of 0 % (n = 5). In the group of patients with T3 high-risk carcinomas, 16.7 % (n = 12) showed a recurrence.


An analysis of the different subgroups has shown that after successful downstaging with neoadjuvant radiochemotherapy, TEM is a curative treatment alternative for T2 low-risk carcinomas. It seems that the degree of downstaging has an effect on the prognosis with regard to the appearance of a local recurrence. The effect of downstaging of T2 low risk carcinomas can possibly be applied to T3 low-risk carcinomas. In the case of high-risk carcinomas, TEM can only be a treatment alternative for comorbid patients or a method for palliation.

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