Postoperative Surveillance after Transanal Excision of Rectal Neoplasms

Local excision for selected rectal cancers remains controversial despite the clear advantage of minimal perioperative morbidity. Local recurrence remains a major problem and no clear algorithm has been reestablished for postoperative follow-up. A simple history and physical evaluation in the office setting may provide the physician a baseline for comparison over time. Routine radiological studies including endorectal ultrasonography, computerized tomography, magnetic resonance imaging, positron emission tomography, and carcinoembryonic antigen immunoscintigraphy to detect local recurrences are recommended by some. A modest benefit has been reported regarding survival for salvage surgical therapy after diagnosis of local recurrence.