Abstract
Purpose This study presents the surgical and postoperative results achieved with a rigid proctoscope using the transanal endoscopic technique to excise rectal adenomas. The results are compared to the results obtained with other currently employed transanal techniques.Methods We investigated the medical records of patients who underwent transanal endoscopic operations from April 2000 to June 2018 at two tertiary referral centers for colorectal cancer.Results This study included 99 patients. The mean age was 65.3 ± 13.3 years. The average size of the adenomas was 4.6 ± 2.3 cm, and their average distance to the anal border was 5.6 ± 3.3 cm. The average operative time was 65.3 ± 41.7 min. In 48.5% of the operations, the specimen was fragmented, and in 59.6% of the cases, the microscopic margins were free. The rates of postoperative complications and relapse were 5% and 19%, respectively. The mean follow-up was 80 ± 61.5 months.Conclusions The described proctoscope proved to be a viable technique with results similar to other techniques, with the advantage that it allowed greater accessibility for surgeons. Therefore, its use could be implemented and become widespread in surgical practice.
Highlights
Colorectal cancer (CRC) is the third most common cancer in men and the second most common cancer in women worldwide and in 25% of cases are located in the rectum
This study presents the surgical and postoperative results achieved with a transanal endoscopic technique that was used to excise rectal adenomas with a rigid surgical proctoscope
It has limitations in that the rectoscope cannot be mobilized at the injury site, rectal lesions located behind a rectal valve can be more difficult to access and remove, and an assistant is required to hold and manipulate the laparoscope during the surgery
Summary
Colorectal cancer (CRC) is the third most common cancer in men and the second most common cancer in women worldwide and in 25% of cases are located in the rectum. Adenoma is the most important type of polyp because it is directly correlated with CRC and originates from the colorectal mucosa, accounting for approximately 70% of all polyps[3,4]. Due to the malignant potential of rectal adenoma, excision is indicated, and the initial treatment consists of endoscopic removal during the diagnostic procedure[5]. When the rectal polyp size and/or location limit its resection by colonoscopy, surgeries are performed. Transanal resection techniques have increasingly replaced invasive surgery in the treatment of premalignant rectal injury[6]
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