Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Transanal Excision of Tumor ++ Stage T1 tumors: Mobile and < 4 cm in diameter.Involving < 40% of the rectal wall circumference.Located within 6 cm of the anal verge.Well or moderately differentiated histology only.Absence of vascular and lymphatic invasion.No evidence of nodal involvement on preoperative rectal ultrasound or MRI. +++ Low Anterior Resection (LAR) with Total Mesorectal Excision ++ Malignant lesion of the rectum diagnosed by evaluation of a tissue biopsy specimen obtained within 2 cm of the anal sphincter in moderately or well-differentiated tumors or within 5 cm for poorly differentiated tumors. +++ Abdominoperineal Resection (APR) with Total Mesorectal Excision ++ Malignant lesion of the rectum diagnosed by evaluation of a tissue biopsy specimen obtained < 2 cm from the anal sphincter for moderately or well-differentiated tumors or < 5 cm for poorly differentiated tumors. +++ Transanal Excision of Tumor ++ Tumors stage greater than T1N0M0.Fixed tumors.Tumors > 4 cm in diameter or involving > 40% of the circumference of the rectal wall.Tumors located > 6 cm from the anal verge.Tumors with poorly differentiated histology or angiolymphatic invasion, or those that show evidence of nodal involvement on preoperative rectal ultrasound or MRI. +++ LAR with Total Mesorectal Excision ++ Malignant lesion of the rectum diagnosed by evaluation of a tissue biopsy specimen obtained < 2 cm from the anal sphincter for moderately or well-differentiated tumors or < 5 cm for poorly differentiated tumors. +++ APR with Total Mesorectal Excision ++ Malignant lesion of the lower rectum diagnosed by evaluation of a tissue biopsy specimen showing local invasion into the pelvic sidewall or pelvis that could benefit from neoadjuvant treatment to facilitate possible curative resection. +++ Transanal Excision of Tumor +++ Expected Benefits ++ Removal of tumor with preservation of anus.Avoidance of radical surgery. +++ Potential Risks ++ Bleeding requiring reoperation.Rectal stricture.Need for further resection based on pathologic findings.Fistula to prostate or vagina.Injury to the urethra for distal anterior tumors in men. +++ LAR or APR with Total Mesorectal Excision +++ Expected Benefits ++ Treatment of rectal cancer.Potential prevention of colonic obstruction, tenesmus, and invasion of adjacent pelvic structures. +++ Potential Risks ++ Bleeding requiring reoperation from presacral or splenic injuries (LAR or APR) or from the anastomosis (LAR).Infection, including intra-abdominal or pelvic abscesses resulting from anastomotic leaks (LAR) or infected intra-abdominal or pelvic fluid collections (LAR or APR).Fistula formation from anastomotic leak (LAR).Postoperative ileus (LAR or APR).Ureteral injury (LAR or APR).Need for a permanent or temporary stoma (LAR).Bladder or sexual dysfunction (LAR ... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth