Clinical and Translational Research
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
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
Processing time: 206 Days and 23.8 Hours
ARTICLE HIGHLIGHTS
Research background

Transanal endoscopic intersphincteric resection (ISR).

Research motivation

Transanal endoscopic ISR surgery currently lacks sufficient clinical research and reporting. In this study, we present the surgical outcomes, perioperative complications, and pathological findings based on the transanal endoscopic ISR surgeries performed in our center, aiming to contribute to the clinical application and development of this technique.

Research objectives

This study utilized a retrospective case series study design. Clinical and pathological data of patients with low rectal cancer who underwent transanal endoscopic ISR at the First Affiliated Hospital of Xiamen University from May 2018 to May 2023 were collected. All patients underwent transanal endoscopic ISR as the surgical approach.

Research methods

This study utilized a retrospective case series study design. Clinical and pathological data of patients with low rectal cancer who underwent transanal endoscopic ISR at the First Affiliated Hospital of Xiamen University from May 2018 to May 2023 were collected. All patients underwent transanal endoscopic ISR as the surgical approach. We conducted a study to report on the perioperative recovery status, postoperative complications, and pathological specimen characteristics of this group of patients.

Research results

This study included a total of 45 eligible cases, with no perioperative deaths. The overall incidence of early complications was 22.22%, with a rate of 4.44% for Clavien-Dindo ≥ III. 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 margin and distal resection margin (DRM) in all patients. The distance between the tumor lower margin and DRM was found to be 2.30 ± 0.62 cm. Transanal endoscopic ISR surgery consistently yields excellent quality pathological specimens.

Research conclusions

In summary, this study provides a report on the transanal endoscopic ISR surgeries performed at our center in recent years. The study found that transanal endoscopic ISR offers excellent surgical visualization and facilitates the protection of the perirectal vasculature and nerves. The procedure has minimal postoperative complications, yields high-quality pathological specimens, and demonstrates excellent oncological outcomes. This research holds valuable implications for the widespread implementation of the transanal endoscopic ISR technique. However, further investigations with larger sample sizes are still warranted.

Research perspectives

Furthermore, there is limited literature available on the long-term efficacy of transanal endoscopic ISR. Subsequent studies conducted by our research team will focus on long-term survival outcomes, utilizing our center’s data, to further validate and explore these aspects.