Full thickness transanal re-excision following endoscopic removal of malignant rectal polyps

Marcovalerio Melis, Renee Gruel, Peter Darwin, Cinthia Drachenberg, David Shibata

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: Segmental resection is recommended for malignant polyps of the colon that are removed endoscopically with questionable margins. However, when such a lesion is present in the rectum, radical resection may involve a higher risk procedure such as low anterior resection or abdominoperineal resection. We report our long-term results in patients treated by transanal re-excision (TAR) following endoscopic removal of malignant rectal polyps (MRP). Methods: Twenty-three patients were identified between 2000 and 2006 as having undergone TAR following complete gross endoscopic removal of an MRP. All lesions demonstrated close, unclear, or microscopically positive polypectomy margins. Results: Our population consisted of 13 men and 10 women with a median age of 61 years (range 52-86). Seventeen (74%) patients demonstrated no evidence of residual tumor. Six patients were found to have residual disease (three adenoma, two adenocarcinoma, one positive lymph node). Morbidity was minimal, and there were no mortalities. At a median follow-up of 64.6 months (range 11-90), there have been no recurrences. Conclusion: We conclude that in approximately one quarter of patients, residual disease is identified following TAR. Given the relatively safety and the low recurrence rate associated with this procedure, TAR may be considered as an alternative to radical resection for MRPs with unsatisfactory margins.

Original languageEnglish (US)
Pages (from-to)531-536
Number of pages6
JournalInternational Journal of Colorectal Disease
Volume24
Issue number5
DOIs
StatePublished - Jan 23 2009

Fingerprint

Polyps
Recurrence
Residual Neoplasm
Rectum
Adenoma
Colon
Adenocarcinoma
Lymph Nodes
Morbidity
Safety
Mortality
Population

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Full thickness transanal re-excision following endoscopic removal of malignant rectal polyps. / Melis, Marcovalerio; Gruel, Renee; Darwin, Peter; Drachenberg, Cinthia; Shibata, David.

In: International Journal of Colorectal Disease, Vol. 24, No. 5, 23.01.2009, p. 531-536.

Research output: Contribution to journalArticle

Melis, Marcovalerio ; Gruel, Renee ; Darwin, Peter ; Drachenberg, Cinthia ; Shibata, David. / Full thickness transanal re-excision following endoscopic removal of malignant rectal polyps. In: International Journal of Colorectal Disease. 2009 ; Vol. 24, No. 5. pp. 531-536.
@article{1ea148e8a069424da089e49161072e3d,
title = "Full thickness transanal re-excision following endoscopic removal of malignant rectal polyps",
abstract = "Purpose: Segmental resection is recommended for malignant polyps of the colon that are removed endoscopically with questionable margins. However, when such a lesion is present in the rectum, radical resection may involve a higher risk procedure such as low anterior resection or abdominoperineal resection. We report our long-term results in patients treated by transanal re-excision (TAR) following endoscopic removal of malignant rectal polyps (MRP). Methods: Twenty-three patients were identified between 2000 and 2006 as having undergone TAR following complete gross endoscopic removal of an MRP. All lesions demonstrated close, unclear, or microscopically positive polypectomy margins. Results: Our population consisted of 13 men and 10 women with a median age of 61 years (range 52-86). Seventeen (74{\%}) patients demonstrated no evidence of residual tumor. Six patients were found to have residual disease (three adenoma, two adenocarcinoma, one positive lymph node). Morbidity was minimal, and there were no mortalities. At a median follow-up of 64.6 months (range 11-90), there have been no recurrences. Conclusion: We conclude that in approximately one quarter of patients, residual disease is identified following TAR. Given the relatively safety and the low recurrence rate associated with this procedure, TAR may be considered as an alternative to radical resection for MRPs with unsatisfactory margins.",
author = "Marcovalerio Melis and Renee Gruel and Peter Darwin and Cinthia Drachenberg and David Shibata",
year = "2009",
month = "1",
day = "23",
doi = "10.1007/s00384-009-0642-1",
language = "English (US)",
volume = "24",
pages = "531--536",
journal = "International Journal of Colorectal Disease",
issn = "0179-1958",
publisher = "Springer Verlag",
number = "5",

}

TY - JOUR

T1 - Full thickness transanal re-excision following endoscopic removal of malignant rectal polyps

AU - Melis, Marcovalerio

AU - Gruel, Renee

AU - Darwin, Peter

AU - Drachenberg, Cinthia

AU - Shibata, David

PY - 2009/1/23

Y1 - 2009/1/23

N2 - Purpose: Segmental resection is recommended for malignant polyps of the colon that are removed endoscopically with questionable margins. However, when such a lesion is present in the rectum, radical resection may involve a higher risk procedure such as low anterior resection or abdominoperineal resection. We report our long-term results in patients treated by transanal re-excision (TAR) following endoscopic removal of malignant rectal polyps (MRP). Methods: Twenty-three patients were identified between 2000 and 2006 as having undergone TAR following complete gross endoscopic removal of an MRP. All lesions demonstrated close, unclear, or microscopically positive polypectomy margins. Results: Our population consisted of 13 men and 10 women with a median age of 61 years (range 52-86). Seventeen (74%) patients demonstrated no evidence of residual tumor. Six patients were found to have residual disease (three adenoma, two adenocarcinoma, one positive lymph node). Morbidity was minimal, and there were no mortalities. At a median follow-up of 64.6 months (range 11-90), there have been no recurrences. Conclusion: We conclude that in approximately one quarter of patients, residual disease is identified following TAR. Given the relatively safety and the low recurrence rate associated with this procedure, TAR may be considered as an alternative to radical resection for MRPs with unsatisfactory margins.

AB - Purpose: Segmental resection is recommended for malignant polyps of the colon that are removed endoscopically with questionable margins. However, when such a lesion is present in the rectum, radical resection may involve a higher risk procedure such as low anterior resection or abdominoperineal resection. We report our long-term results in patients treated by transanal re-excision (TAR) following endoscopic removal of malignant rectal polyps (MRP). Methods: Twenty-three patients were identified between 2000 and 2006 as having undergone TAR following complete gross endoscopic removal of an MRP. All lesions demonstrated close, unclear, or microscopically positive polypectomy margins. Results: Our population consisted of 13 men and 10 women with a median age of 61 years (range 52-86). Seventeen (74%) patients demonstrated no evidence of residual tumor. Six patients were found to have residual disease (three adenoma, two adenocarcinoma, one positive lymph node). Morbidity was minimal, and there were no mortalities. At a median follow-up of 64.6 months (range 11-90), there have been no recurrences. Conclusion: We conclude that in approximately one quarter of patients, residual disease is identified following TAR. Given the relatively safety and the low recurrence rate associated with this procedure, TAR may be considered as an alternative to radical resection for MRPs with unsatisfactory margins.

UR - http://www.scopus.com/inward/record.url?scp=63649143886&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=63649143886&partnerID=8YFLogxK

U2 - 10.1007/s00384-009-0642-1

DO - 10.1007/s00384-009-0642-1

M3 - Article

VL - 24

SP - 531

EP - 536

JO - International Journal of Colorectal Disease

JF - International Journal of Colorectal Disease

SN - 0179-1958

IS - 5

ER -