Future directions in surgery for colorectal cancer: the evolving role of transanal endoscopic surgery. (April 2014)

• Record Type: Journal Article
• Authors: Emhoff, Isha Ann; Lee, Grace Clara; Sylla, Patricia
• Is Part Of: Colorectal cancer. Volume 3:Number 2(2014)
• Page Start: 195
• Page End: 213
• Publication Date: 2014-04
• Subjects: Colon (Anatomy) -- Cancer -- Periodicals; Rectum -- Cancer -- Periodicals; 616.994347
• DOI: 10.2217/crc.14.8
• Languages: English
• ISSNs: 1758-194X

Abstract

SUMMARY : The morbidity associated with radical surgery for rectal cancer has launched a revolution in increasingly less-invasive methods of resection, including a recent resurgence in transanal endoscopic surgical approaches. The next evolution in transanal surgery for rectal cancer is natural orifice translumenal endoscopic surgery (NOTES). To date, 14 series of transanal NOTES total mesorectal excision (TME) for rectal cancer have been published (n = 76). Overall, the intraoperative and postoperative complication rates of 8 and 28%, respectively, compare favorably to those expected from laparoscopic and open TME. Short-term follow-up after NOTES TME has yielded no cancer recurrence in average-risk patients. High-risk patients have cancer recurrence rates similar to those after laparoscopic TME. Overall, these early data support transanal NOTES TME as a safe and viable alternative to conventional TME. Advances in instrumentation, surgical expertise and neoadjuvant treatment may expand current indications for NOTES even further.