Selection and application of transanal local excision techniques in the context of multimodal therapy for rectal cancer
10.3760/cma.j.cn441530-20250818-00308
- VernacularTitle:直肠癌综合治疗背景下经肛局部切除技术的选择与运用
- Author:
Yanan WANG
1
;
Ke XU
1
;
Tingyu MOU
1
;
Zhenghao LI
1
;
Yang ZHAO
1
Author Information
1. 南方医科大学南方医院普通外科，广州 510515
- Publication Type:Journal Article
- Keywords:
Rectal neoplasms;
Local excision;
Multimodal therapy;
Organ preservation
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(11):1237-1242
- CountryChina
- Language:Chinese
-
Abstract:
In the field of rectal cancer treatment, transanal local excision techniques (such as transanal endoscopic microsurgery [TEM] and transanal minimally invasive surgery [TAMIS]) have gradually become an important therapeutic option for patients with rectal cancer at various stages, owing to their minimally invasive characteristics and organ-preserving advantages. For low-risk T1 stage tumors, local excision can achieve radical tumor control while preserving organ function. For some patients with high-risk T1 stage or T2-3 stage rectal cancer, the efficacy of combined chemoradiotherapy and local excision is expected to be comparable to that of radical total mesorectal excision (TME). In patients with advanced rectal cancer who achieve clinical complete response (cCR) after neoadjuvant therapy, local excision can confirm the pathological remission status. However, it is necessary to balance the risk of surgical complications against the potential benefits of organ preservation with the "watch and wait" strategy. Currently, transanal local excision techniques have broad application prospects, and comprehensive assessment of patients' overall condition, implementation of multidisciplinary collaboration, and conduct of long-term follow-up are crucial to ensuring the safety of treatment.
