Abstract
T ota l mesorectal excision is the “golden standard” of surgical treatment for rectal cancer. Development of endoscopic technologies allowed to implement the benefits of minimally invasive surgery in early rectal cancer treatment, decrease morbidity and mortality, improve functional outcome and quality of life. Oncological safety of this method is still a subject for discussion due to lack of lymph node harvest. Endoscopic operations for early rectal cancer are being actively implemented in daily practice, but lack of experience does not allow to include this method in national clinical prac-tice guidelines.
Highlights
Development of endoscopic technologies allowed to implement the benefits of minimally invasive surgery in early rectal cancer treatment, decrease morbidity and mortality, improve functional outcome and quality of life
Endoscopic operations for early rectal cancer are being actively implemented in daily practice, but lack of experience does not allow to include this method in national clinical prac-tice guidelines
Авторы сделали вывод, что при минимальном риске регионарного метастазирования ESD обеспечивает достаточный уровень моноблочного и радикального удаления ранней опухоли, являясь более безопасным методом, чем лапароскопические вмешательства
Summary
Около 20 лет назад была внедрена методика эндоскопической резекции слизистой оболочки (endoscopic mucosal resection – EMR), которая и сейчас используется для удаления неинвазивного рака прямой кишки (Tis). Проведенное JSCCR проспективное многоцентровое исследование [17], включавшее 1845 пациентов, показало, что при протяженности опухоли прямой кишки не более 20 мм EMR позволила моноблочно удалить ее только в 56,9 % случаев, тогда как при ESR этот показатель достигал 93 % даже при опухолях, превышающих 40 мм.
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