Han J, et al. – In this study, authors shared their experience with the transanal endoscopic operation (TEO) and transanal excision (TAE) for rectal tumors. In addition, they compared patients who underwent TEO and TAE using propensity score matching (PSM). They recognized TEO as more beneficial for patients with higher rectal tumors. Regardless of tumor location, involved circumference quadrants, and tumor size, TEO seemed more efficacious in achieving negative resection margins and non–fragmented specimens. Consequently, although local excision method according to tumor distance may be important, TEO would become the standard for rectal tumors.

Methods

• From January 2008 to November 2015, authors identified 207 patients who underwent local rectal tumor excision.
• To overcome selection bias, PSM was used to achieve a one-to-one TEO: TAE ratio.
• They assessed baseline characteristics, age, sex, surgeon, American Society of Anesthesiologists score, tumor location (clockwise direction), involved circumference quadrants, tumor size, and pathology.

Results

• After PSM, authors included 72 patients in each group.
• In the TEO group, tumor distance from the anal verge was higher (8.0 [5–10] vs. TAE: 4.0 [3–5], p < 0.001).
• The groups were comparable regarding complication rates (TEO: 8.3% vs. TAE: 11.1%, p = 0.39).
• In this study, TEO seemed associated with a shorter hospital stay (3.01 vs. 4.68 days, p = 0.001), higher negative margin rate (95.8 vs. 86.1%, p = 0.039), and non-fragmented specimen rate vs. TAE (98.6 vs. 90.3%, p = 0.029).