Clinical study of local excision procedures for rectal tumors

Clinical study of three different local excision procedures for rectal tumors was undertaken to evaluate the new local excision procedure using an E retractor and a stapler (minimally invasive transanal surgery, MITAS). Forty-three patients underwent local excision for rectal tumors. Twenty-four of them were operated on by MITAS for 25 lesions, 17 by peranal local excision (PAE) for 17 lesions and two by transsacral local excision (TSE) for two lesions. The maximum diameter of the lesions was not different among the three procedures, but the distance from the anal verge to the proximal margin of the tumor in patients receiving MITAS was significantly longer that in those treated by the other procedures. The mean operative time and blood loss were 28 minutes and 25 g in MITAS, 41 minutes and 47 g in PAE, and 73 minutes and 45 g in TSE. The times for starting oral intake and discharge afte MITAS were shorter than those after the other procedures. Two anastomotic leakages were observed after PAE, and one transient bleeding afte MITAS, and there was no trouble after TSE. MITAS was considered to be a minimally invasive local excision procedure which enables an approach to a more proximal lesion than the other local excision procedures.