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Transanal endoscopic microsurgery for rectal cancer
E J R de Graaf1, P G Doornebosch, L P S Stassen
1Department of Surgery, IJsselland Hospital, Capelle aan den IJssel, The Netherlands. edgraaf@ysl.nl
European Journal of Cancer (Oxford, England : 1990)
|April 30, 2002
Summary
Transanal endoscopic microsurgery (TEM) offers a minimally invasive approach for rectal cancer local resection. TEM demonstrates minimal complications and comparable outcomes to traditional surgery for early-stage rectal cancer.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Minimally Invasive Procedures
Background:
- Total mesorectal excision (TME) is the standard for rectal cancer surgery.
- Transanal resection has limitations in tumor control, restricting its use.
- Transanal endoscopic microsurgery (TEM) emerged as a minimally invasive alternative.
Purpose of the Study:
- To evaluate the efficacy and safety of Transanal Endoscopic Microsurgery (TEM) for rectal cancer.
- To compare TEM outcomes with traditional Total Mesorectal Excision (TME).
- To reassess TEM's role in curative-intent local excision of rectal cancer.
Main Methods:
- TEM utilizes a transanal, one-port system with advanced optics and specialized instruments.
- It enables full-thickness rectal tumor excision under excellent visualization.
- The technique allows for creation of a stable pneumorectum for precise surgery.
Main Results:
- TEM is associated with minimal mortality, morbidity, and incomplete excision rates.
- Local recurrence and survival rates appear comparable to TME in early rectal cancer.
- The technique is applicable to larger and more proximal rectal tumors.
Conclusions:
- Transanal endoscopic microsurgery (TEM) is the preferred method for indicated local rectal cancer resection.
- TEM results support its use for curative-intent local excision.
- Further evaluation of TEM indications for rectal cancer is warranted.