Objective: To explore the indication and efficacy of transanal local excision for low rectal cancer.
Methods: A total of 40 consecutive patients undergoing transanal local excision of low rectal cancer were analyzed retrospectively.
Results: The mean operative time was 50 (30-85) minutes. The mean intraoperative blood loss was 40 (10-100) ml. The mean hospital stay was 5 (2-10) days. The local recurrence rate was 20.0% (8/40). The 5-year survival rate was 90.0%. Local recurrence rate was 17.9% (5/28 cases) for T1, and 25.0% (3/12) for T2 lesions. However, the difference between the two groups was not statistically significant (P=0.61). Local recurrence rate was significantly lower for moderate differentiated than that for well-differentiated cancer [12.9% (4/31) vs. 44.4% (4/9), P=0.037]. Tumor diameter less than 3 cm was associated with a significantly lower local recurrence rate as compared to the counterparts (10.7% vs. 41.7%, P=0.03). No significant correlations were found between local recurrence and other variables including tumor location (P=0.93), tumor classification (P=0.53), and method of surgical excision (P=0.41).
Conclusions: Indications for transanal local excision of low rectal cancer include T1 and T2 tumors with well differentiation and the diameter less than 3 cm. Clinical outcome may be favorable if patients are carefully selected for transanal local excision.