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Related Experiment Videos

Transanal endoscopic microsurgery: experience with 75 rectal neoplasms.

D Lev-Chelouche1, D Margel, G Goldman

  • 1Department of Surgery B&C, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Israel.

Diseases of the Colon and Rectum
|May 29, 2000
PubMed
Summary

Transanal endoscopic microsurgery (TEM) is a safe and effective treatment for rectal tumors. This technique shows promise for benign and early-stage malignant rectal neoplasms, with low complication rates.

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Area of Science:

  • Colorectal Surgery
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Transanal endoscopic microsurgery (TEM) is a minimally invasive surgical technique for rectal lesions.
  • Experience with TEM for both benign and malignant rectal tumors is valuable for establishing its efficacy and safety profile.

Purpose of the Study:

  • To report the single-institution experience with transanal endoscopic microsurgery (TEM) for patients diagnosed with benign and malignant rectal tumors.
  • To evaluate the safety, efficacy, and outcomes of TEM in a diverse patient cohort.

Main Methods:

  • A retrospective review of 75 patients who underwent TEM for benign (46) or malignant (29) rectal tumors between January 1992 and April 1998.
  • Tumors were located 3 to 18 cm from the dentate line, with a mean follow-up of 38 months.

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Main Results:

  • For benign tumors, 6.5% required conversion to radical surgery, and 9% experienced recurrence, managed effectively with repeat TEM or radical surgery.
  • For malignant tumors (T1-T3), 18% had recurrence, with management including repeat TEM, radical surgery, or laser ablation. No cancer-related deaths occurred.
  • Postoperative complications were minor, with one operative mortality in a high-risk patient. Rectourethral fistula and transient fecal soiling were noted.

Conclusions:

  • Transanal endoscopic microsurgery (TEM) is a safe, precise, and well-tolerated technique, even in high-risk patients.
  • TEM is a viable option for benign rectal tumors and selected early-stage malignant rectal neoplasms.
  • The procedure demonstrates a favorable safety profile with manageable complications and good long-term outcomes.