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Transanal endoscopic microsurgery: clinical and functional results
1Department of Surgery, University Hospital, Uppsala, Sweden. george.dafnis@telia.com
Summary
Transanal endoscopic microsurgery (TEM) is a safe rectal procedure with low recurrence rates for adenomas and cancers. While functional outcomes are acceptable, some patients experience temporary incontinence.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Procedures
- Oncology
Background:
- Transanal endoscopic microsurgery (TEM) is increasingly utilized for rectal adenomas and selected rectal carcinomas.
- This study evaluates the outcomes of TEM in a consecutive patient series.
Purpose of the Study:
- To assess the safety, recurrence rates, and functional outcomes of Transanal Endoscopic Microsurgery (TEM).
Main Methods:
- A retrospective review of 58 patients who underwent TEM between January 1996 and January 1999.
- Forty-eight patients completed a validated questionnaire regarding functional outcomes.
- Recurrence rates were compared to historical controls.
Main Results:
- The overall complication rate was 5% immediate and 14% long-term, with zero 30-day mortality.
- Continence impairment was observed in 37% of patients, primarily affecting liquid stool and flatus.
- Recurrence rates were 11% for adenomas and 14% for cancers, with higher rates in T2 stage.
Conclusions:
- Transanal endoscopic microsurgery (TEM) demonstrates a low recurrence rate and acceptable functional outcomes.
- TEM is a safe and effective surgical option for specific rectal pathologies.