Additional Surgical Resection After Endoscopic Resection for Patients With High-risk T1 Colorectal Cancer

In Vivo. 2019 Jul-Aug;33(4):1243-1248. doi: 10.21873/invivo.11596.

Abstract

Background/aim: The purpose of this study was to reveal the safety and efficacy of additional surgical resection (ASR) for high-risk T1 colorectal cancer (CRC) after endoscopic resection (ER).

Patients and methods: We retrospectively analyzed 191 patients with high-risk T1 CRC after ER.

Results: The ASR was performed in 176 (92.1%) patients and 15 (7.9%) rejected ASR. All patients that underwent ASR experienced R0 resection; laparoscopic surgery was performed in 159 (90.3%) patients. Clavien-Dindo complications ≥grade II occurred in 33 patients (18.8%). Anastomotic leakage (8.5%) and ileus (5.7%) were the most frequent complications. The anus function was preserved in all patients. Metastatic lymph node was detected in 21 (11.9%) patients. There were no deaths or relapses in patients with ASR. One patient without ASR (6.7%) had a lymph node recurrence.

Conclusion: ASR was safe and effective and is recommended for high-risk T1 CRC patients after ER. A satisfactory long-term outcome can be achieved.

Keywords: Colorectal surgery; colorectal neoplasms; endoscopy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / surgery*
  • Colorectal Surgery / adverse effects
  • Colorectal Surgery / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Retreatment
  • Treatment Outcome
  • Tumor Burden