Full-Thickness Local Excision

  • Lauren A. Kosinski
  • John H. Marks
  • Gerald J. Marks

In 1984 when we first ventured to perform a full-thickness disc excision of a distal rectal cancer after full-dose radiation therapy in an elderly, medically compromised woman, we were filled with wonder. Would the reconstructed radiated rectum heal? Would there be long-term local control of the cancer? In contrast to a radical resection of the rectum following irradiation, where nonirradiated, proximal descending colon is anastomosed to an irradiated rectal remnant, a local excision involves approximation of irradiated tissue.

The foundation for this approach was laid beginning in 1976 when we began administering high-dose neoadjuvant therapy before performing radical proctectomies. The experience we gained operating in the irradiated pelvis emboldened us to adapt this approach for the medically inoperable patient with rectal cancer. The next evolution occurred with the introduction of transanal endoscopic microsurgery (TEM) and our utilization of this technique in patients treated...


Rectal Cancer Local Excision Local Recurrence Rate Rectal Prolapse Transanal Endoscopic Microsurgery 
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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Lauren A. Kosinski
    • 1
  • John H. Marks
  • Gerald J. Marks
  1. 1.Lankenau, Bryn Mawr, and Paoli HospitalsWynnewoodUSA

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