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Related Experiment Videos

Transanal endoscopic microsurgery: a systematic review.

Philippa F Middleton1, Leanne M Sutherland, Guy J Maddern

  • 1ASERNIP-S, Royal Australasian College of Surgeons, Adelaide, Australia. college.asernip@surgeons.org

Diseases of the Colon and Rectum
|February 16, 2005
PubMed
Summary
This summary is machine-generated.

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Transanal endoscopic microsurgery (TEM) shows fewer local recurrences for rectal adenomas compared to direct local excision. While evidence for carcinomas is limited, TEM may be a cost-effective option for specific patient groups.

Area of Science:

  • Colorectal Surgery
  • Minimally Invasive Procedures
  • Oncology

Background:

  • Transanal endoscopic microsurgery (TEM) is an emerging technique for local rectal tumor excision.
  • Comparative data on TEM versus traditional resections (anterior resection, abdominoperineal resection) and local excision are needed.

Purpose of the Study:

  • To systematically review the safety and efficacy of TEM compared to existing rectal tumor excision techniques.
  • To evaluate recurrence rates, complication rates, and costs associated with TEM.

Main Methods:

  • Systematic review of comparative studies and case series of TEM from 1980 to August 2002.
  • Included one randomized controlled trial and 55 case series.

Main Results:

Related Experiment Videos

  • For adenomas, TEM showed significantly lower local recurrence rates (6% vs. 22%) than direct local excision, with similar early complication rates.
  • For carcinomas, no significant differences in complications, survival, or local recurrence were found between TEM and anterior resection in limited comparative data.
  • TEM demonstrated lower costs compared to local excision and anterior resection for adenomas, and lower costs than anterior/abdominoperineal resection for carcinomas.

Conclusions:

  • Evidence for TEM is limited, primarily from one small randomized controlled trial.
  • TEM appears to reduce local recurrences for rectal adenomas compared to direct local excision.
  • TEM may be a valuable option for specific indications like large benign rectal lesions, T1 low-risk cancers, or palliative treatment.