Results of long-term follow-up for transanal excision for XXXX .

@entity1 @entity1619 @entity5 @entity190 @entity420
Low anterior resection and abdominoperineal resection are the surgical techniques used most frequently in the treatment of @entity5 . It is our hypothesis that selected @entity1 with @entity1619 stage, well or moderate grade of differentiation, and small @entity5 size are good candidates for transanal excision in terms of minimal morbidity, low recurrence rate, and sphincter preservation. From January 1993 until August 2001 30 @entity1 underwent transanal excision; three @entity1 were excluded because they had histology other than @entity420 . Factors analyzed included those related to the @entity1 [age (years), gender, race, body mass index, and anal tone], @entity5 [size (cm), distance from the anal verge (cm), differentiation, and American Joint Committee on @entity5 stage], and additional treatment. Median follow-up of the group was 40.7 months (range 0.6-99) and the primary end points were local and distant recurrence. Data are presented as mean (range). The median age of the group was 58.9 years (range 27-94); 52 per cent were female and 48 per cent were male. The mean body mass index was 25.9 (range 22.7-36.7). Preoperatively 81, 11, and 4 per cent of the @entity1 had stage I, II, and III/IV @entity5 , respectively. Preoperative size of the @entity5 was 2.0 cm (1-3 cm), and distance from the anal verge was 5.0 cm (3-15 cm). @entity190 was 50 cm3 (5-200 cm3), and there were no operative complications. @entity5 differentiation levels were well (37%) and moderate (63%). All @entity1 had negative margins. Additional treatment consisted of radiation therapy in seven @entity1 (six postoperative and one preoperative). Chemotherapy was given to seven @entity1 (six postoperative and one preoperative). The local recurrence rate was 7.4 per cent (two @entity1 ), and 3.7 per cent recurred distantly (one @entity1 ). Transanal excision of @entity5 in selected @entity1 is an acceptable alternative to formal resection. Important selection criteria include @entity1619 stage, well or moderate differentiation, relatively small @entity5 size, and negative microscopic margins. The roles of radiation and chemotherapy remain controversial.
