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Transanal endoscopic microsurgery: indications and results after 100 cases
P Palma1, S Freudenberg, S Samel
1Department of Surgery, University Clinic, Mannheim, Germany. pablo.palma@chir.ma.uni-heidelberg.de
Summary
Transanal endoscopic microsurgery (TEM) effectively removes benign rectal tumors and selected early-stage cancers. This minimally invasive approach offers superior visualization and precision for rectal tumor excision.
Area of Science:
- Colorectal surgery
- Minimally invasive surgical techniques
- Oncology
Background:
- Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for rectal tumor excision.
- Its use for benign and selected malignant rectal tumors has been established since 1998.
Purpose of the Study:
- To prospectively evaluate the indications and outcomes of TEM.
- To analyze the effectiveness of TEM in treating various rectal pathologies.
Main Methods:
- A prospective descriptive study involving 100 patients over 4 years.
- TEM was used for rectal tumors located between 4 and 18 cm from the anal verge.
Main Results:
- TEM was performed for adenomas (71), low-grade carcinoma (20), palliative advanced carcinoma (3), carcinoids (5), and solitary ulcers (1).
- Complications included wound breakdown (7) and conversion to laparotomy (2). Recurrences were successfully managed with TEM or further surgery.
- Salvage therapy and palliative procedures were employed for advanced or recurrent cancers.
Conclusions:
- TEM is effective for excising benign rectal tumors and selected T1 carcinomas.
- The technique provides superior exposure and precision, making it an attractive surgical option for rectal lesions.