Outcome following rectal resection after transanal endoscopic microsurgery (TEM): F08

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Aim:The UK TEM database has collected data on over 500 cancers since 1993. This analysis examined the outcomes of those patients whoproceeded to rectal resection.Method:Case note review was performed in 29 cases identified from the UK TEM database who underwent completion resection on the basis of unfavourable pathology.Results:Surgery performed included anterior resection (n = 25), abdominoperineal resection (n = 3) and Hartmann's resection (n = 1). Resection was undertaken at a mean interval of 66.2 days (range 14-197). Mean length of stay after resection was 16.1 days (range 6 < 51). Residual cancer was found in 10/29 at the TEM site, 3/29 had no residual cancer but had lymph node involvement and 16/29 had no residual or metastatic disease. 5/29 patients had a permanent stoma, 19/29 a temporary stoma (84.2% reversal rate) and 5/29 patients avoided a stoma. No post operative mortality within 30 days, six have died of metastatic disease and to date, 20 have no evidence of recurrence.Discussion:The study suggests that completion surgery after TEM has similar complications and stoma formation rates toprimary radical surgery supporting a role for TEM in the treatment strategy for rectal cancer.

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