Xu ZW, Zhu JT, Bai HY, Yu XJ, Hong QQ, You J. Clinical efficacy and pathological outcomes of transanal endoscopic intersphincteric resection for low rectal cancer. World J Gastrointest Oncol 2024; 16(3): 933-944 [PMID: 38577453 DOI: 10.4251/wjgo.v16.i3.933]
Corresponding Author of This Article
Jun You, PhD, Professor, Department of Gastrointestinal Oncology Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, No. 55 Zhenhai Road, Xiamen 361000, Fujian Province, China. youjun@xmu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Clinical and Translational Research
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Mar 15, 2024; 16(3): 933-944 Published online Mar 15, 2024. doi: 10.4251/wjgo.v16.i3.933
Clinical efficacy and pathological outcomes of transanal endoscopic intersphincteric resection for low rectal cancer
Zhi-Wen Xu, Jing-Tao Zhu, Hao-Yu Bai, Xue-Jun Yu, Qing-Qi Hong, Jun You
Zhi-Wen Xu, Jing-Tao Zhu, Hao-Yu Bai, Xue-Jun Yu, Qing-Qi Hong, Jun You, Department of Gastrointestinal Oncology Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361000, Fujian Province, China
Author contributions: You J and Hong QQ designed the research; Xu ZW performed the research; Zhu JT and Bai HY contributed new reagents or analytic tools; Xu ZW and Yu XJ analyzed the data; Xu ZW wrote the paper.
Institutional review board statement: The study was reviewed and approved by the institutional review boards of First Affiliated Hospital of Xiamen University.
Informed consent statement: Patient consent was waived due to the retrospective character of the study, and it was approved by the Ethics Committee at the First Affiliated Hospital of Xiamen University. All procedures performed in studies involving human participants were conducted according to the ethical standards of the institutional research committee and the Helsinki declaration and later revision.
Conflict-of-interest statement: The authors of this manuscript having no conflicts of interest to disclose.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun You, PhD, Professor, Department of Gastrointestinal Oncology Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, No. 55 Zhenhai Road, Xiamen 361000, Fujian Province, China. youjun@xmu.edu.cn
Received: August 18, 2023 Peer-review started: August 18, 2023 First decision: October 23, 2023 Revised: November 5, 2023 Accepted: December 29, 2023 Article in press: December 29, 2023 Published online: March 15, 2024
Abstract
BACKGROUND
Transanal endoscopic intersphincteric resection (ISR) surgery currently lacks sufficient clinical research and reporting.
AIM
To investigate the clinical effectiveness of transanal endoscopic ISR, in order to promote the clinical application and development of this technique.
METHODS
This study utilized a retrospective case series design. Clinical and pathological data of patients with lower rectal cancer who underwent transanal endoscopic ISR at the First Affiliated Hospital of Xiamen University between May 2018 and May 2023 were included. All patients underwent transanal endoscopic ISR as the surgical approach. We conducted this study to determine the perioperative recovery status, postoperative complications, and pathological specimen characteristics of this group of patients.
RESULTS
This study included 45 eligible patients, with no perioperative mortalities. The overall incidence of early complications was 22.22%, with a rate of 4.44% for Clavien-Dindo grade ≥ III events. Two patients (4.4%) developed anastomotic leakage after surgery, including one case of grade A and one case of grade B. Postoperative pathological examination confirmed negative circumferential resection margins and distal resection margins in all patients. The mean distance between the tumor lower margin and distal resection margin was found to be 2.30 ± 0.62 cm. The transanal endoscopic ISR procedure consistently yielded high quality pathological specimens.
CONCLUSION
Transanal endoscopic ISR is safe, feasible, and provides a clear anatomical view. It is associated with a low incidence of postoperative complications and favorable pathological outcomes, making it worth further research and application.
Core Tip: In recent years, our center has conducted extensive research and accumulated experience in transanal endoscopic intersphincteric resection (ISR) procedures. In this study, we present the surgical outcomes, perioperative complications, and pathological findings based on the transanal endoscopic ISR surgeries performed in our center to contribute to the clinical application and development of this technique.
