{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:09:32Z","timestamp":1789387772585,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,10,24]],"date-time":"2013-10-24T00:00:00Z","timestamp":1382572800000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Patients with unfavourable pathology after transanal endoscopic microsurgery (<jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content>) should be offered completion surgery (<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>) if appropriate. The aim of this retrospective cohort study was to assess the short\u2010term outcome and long\u2010term oncological results of <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> and identify factors compromising the quality of resection specimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Data were retrieved and analysed on patients who underwent <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> from a comprehensive national <jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content> database (1992\u20132008) and the institutional prospective database from the <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>xford <jats:styled-content style=\"fixed-case\">U<\/jats:styled-content>niversity <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>ospitals (2008\u20132011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 36 patients eligible for analysis. Postoperative complications occurred in 19 and were minor (grade <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>\u2013<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>) in 13 and major (grade <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\u2013<jats:styled-content style=\"fixed-case\">V<\/jats:styled-content>) in six patients. The quality of the resected specimen was graded as good in 23 (64%), moderate in six (16.6%) and poor in seven (19.4%). Full\u2010thickness excision by <jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content> (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.03), an interval to <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> greater than 7\u00a0weeks (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.05) and distally located lesions (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.04) were associated with increased risk for an inferior surgical specimen. Overall survival after <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> was 91% at 1\u00a0year and 83% at 5\u00a0years. Patients with a \u2018good\u2019 <jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> specimen had significantly improved disease\u2010free survival compared with patients with an \u2018inferior\u2019 specimen (100 <jats:italic>vs<\/jats:italic> 51%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients having full\u2010thickness <jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content> excision, distally placed lesions and a long interval (&gt;\u00a07\u00a0weeks) to <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> were likely to have an inferior <jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> specimen. The results confirm that <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> after <jats:styled-content style=\"fixed-case\">TEM<\/jats:styled-content> does not negatively influence local recurrence and survival, but the reduced disease\u2010free survival in patients with an inferior specimen is of concern.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12381","type":"journal-article","created":{"date-parts":[[2013,8,12]],"date-time":"2013-08-12T11:19:01Z","timestamp":1376306341000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":92,"title":["Completion surgery following transanal endoscopic microsurgery: assessment of quality and short\u2010 and long\u2010term outcome"],"prefix":"10.1111","volume":"15","author":[{"given":"R.","family":"Hompes","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Oxford University Hospitals Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Oxford University Hospitals Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Buskens","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Lindsey","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Oxford University Hospitals Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Armitage","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Nottingham University Hospitals Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Central Manchester University Hospitals Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery University Hospitals of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. J.","family":"Mortensen","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Oxford University Hospitals Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Oxford University Hospitals Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The Association of Coloproctology of Great Britain and Ireland Transanal Endoscopic Microsurgery Collaboration","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010580"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.2000.01357.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000252590.95116.4f"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2011.02778.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-010-1347-9"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181a0d06d"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6456"},{"key":"e_1_2_8_9_1","first-page":"A4507","article-title":"The outcome of rectal cancer after early salvage surgery following transanal endoscopic microsurgery seems promising","volume":"59","author":"Levic K","year":"2012","journal-title":"Dan Med J"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0900-9"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0587-1"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-002-8814-x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5678"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60485-2"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soc.2004.11.007"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2009.04859.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2009.02.013"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181dae4ed"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181e73f33"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5348.13"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.12381","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.12381","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:33:06Z","timestamp":1696293186000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.12381"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2013,10]]}},"alternative-id":["10.1111\/codi.12381"],"URL":"https:\/\/doi.org\/10.1111\/codi.12381","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10]]},"assertion":[{"value":"2013-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-04-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-10-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}