Transanal endoscopic microsurgery--lessons from a single UK centre series.

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Oncology

Background:

• Transanal endoscopic microsurgery (TEM) is a minimally invasive approach for rectal tumor excision.
• Since 1983, TEM has been utilized for benign and selected malignant rectal tumors.
• This study reviews a single surgeon's experience with 102 TEM procedures.

Purpose of the Study:

• To evaluate the efficacy of TEM in a series of rectal tumor excisions.
• To assess outcomes for benign tumors, curative excisions of carcinoma, and palliative procedures.
• To determine the role of TEM in treating various stages of rectal cancer.

Main Methods:

• Retrospective review of 102 TEM procedures performed between 1996 and 2001.
• Analysis of patient data including tumor type, stage, and treatment outcomes.
• Inclusion of data on recurrences and subsequent management.

Main Results:

• 68 adenomas, 19 T1/T2 carcinomas (curative intent), 13 palliative procedures, and 2 solitary rectal ulcer syndromes (SRUS) were treated.
• Four adenomas recurred but were successfully managed without malignancy.
• Of 16 curative excisions for T1/T2 carcinomas, all showed no recurrence; 3 T3 cancers required further treatment.
• Two of 11 palliative TEM procedures had symptom recurrence, successfully treated with repeat TEM.

Conclusions:

• TEM is effective for excising benign rectal tumors and T1 carcinomas.
• The role of TEM in T2 rectal carcinoma treatment requires further investigation, though results are encouraging.
• Longer-term follow-up is necessary to fully establish TEM's efficacy in rectal cancer management.