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Transanal endoscopic microsurgery for rectal cancer.
Simon D Duek1, Michael M Krausz, Dan D Hershko
1Department of Surgery A, Rambam Medical Center, Haifa, Israel. d_duek@rambam.health.gov.il
The Israel Medical Association Journal : IMAJ
|July 14, 2005
Summary
Transanal endoscopic microsurgery (TEM) is a safe, minimally invasive option for selected early rectal cancer patients. This technique offers curative management for rectal adenomas and early-stage rectal cancer with low recurrence rates.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Surgery
- Oncology
Background:
- Transanal endoscopic microsurgery (TEM) is an emerging minimally invasive surgical technique.
- It is increasingly accepted for managing large rectal adenomas and early rectal cancers.
Purpose of the Study:
- To evaluate the 8-year experience with TEM in rectal cancer management.
- To analyze the safety and efficacy of TEM for rectal tumors.
Main Methods:
- TEM was used for local resection of benign tumors and early rectal cancer.
- Selected T2 and T3 rectal cancer patients, unfit for radical surgery, were also treated with TEM.
- Radical surgery was reserved for cases with incomplete TEM tumor excision.
Main Results:
- 116 TEM operations were performed between 1995 and 2003 (74 adenomas, 42 carcinomas).
- TEM achieved complete T1 tumor resection in 25 patients.
- For T2 cancers, 21% required additional surgery due to incomplete excision, with one local recurrence and five major complications.
Conclusions:
- Local excision via TEM is a safe procedure.
- TEM should be considered for highly selected patients with early rectal cancer.