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[Transanal endoscopic microsurgery: technique and clinical results]
S Said1, L Chiavellati, H Pichlmaier
1Chirurgische Universitätsklinik Köln-Lindenthal, Università degli Studi di Roma, La Sapienza.
Minerva Chirurgica
|June 30, 1992
Summary
Transanal endoscopic microsurgery (TEM) offers a minimally invasive approach for rectal conditions. This technique effectively removes adenomas and early rectal cancers, with a low complication and recurrence rate, avoiding extensive surgery.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Surgery
- Gastroenterology
Background:
- Transanal endoscopic microsurgery (TEM) is a specialized technique for rectal procedures.
- Conventional surgical options for rectal adenomas and early carcinomas can be invasive.
Purpose of the Study:
- To evaluate the efficacy and safety of a new TEM system for rectal lesion excision.
- To assess the suitability of TEM for various rectal conditions, including adenomas and early cancers.
Main Methods:
- The study utilized a new TEM system on 206 patients over 223 cases.
- Local excision was performed for sessile adenomas and early rectal carcinomas.
- Advanced cancer cases were treated with TEM only when radical surgery was contraindicated or refused.
Main Results:
- Histological confirmation of sufficient excision was achieved in 87.7% of cases after a single local excision.
- The postoperative complication rate was low, with 93.3% of patients experiencing no complications.
- The recurrence rate for adenomas was 5.2%.
Conclusions:
- TEM is a safe and effective minimally invasive option for rectal adenomas and early cancers.
- This technique is particularly beneficial for elderly, high-risk patients, and those with broad-based adenomas.
- TEM allows for the avoidance of more invasive procedures like anterior or abdominoperineal resection.