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TEM/local excision: indications, techniques, outcomes, and the future
1Rush Medical College Head, Section of Colon and Rectal Surgery, Rush University Medical Center, Chicago, Illinois, USA. eileen_j_pehanich@rush.edu
Journal of Surgical Oncology
|December 18, 2007
Summary
Transanal endoscopic microsurgery (TEM) offers a safe approach for removing rectal adenomas and select cancers. This minimally invasive technique also treats complex fistulae and strictures with few complications.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Minimally Invasive Procedures
Background:
- Rectal adenomas and certain cancers require effective and safe removal methods.
- Complex anorectal conditions like fistulae and strictures present surgical challenges.
Purpose of the Study:
- To evaluate the safety and efficacy of Transanal Endoscopic Microsurgery (TEM).
- To explore the extended applications of TEM in treating various anorectal pathologies.
Main Methods:
- TEM utilizes a specialized endoscopic platform with magnification and CO2 insufflation.
- The technique allows for precise excision and closure of rectal lesions and fistulae.
- Procedures are performed using long-shafted instruments within an air-tight system.
Main Results:
- TEM is a safe and effective method for excising rectal adenomas and selected cancers.
- Successful application of TEM in treating extra- and supra-sphincteric fistulae, rectovaginal fistulae, anastomotic strictures, and sinus tracts.
- The procedure facilitates clear margins during excision and closure.
Conclusions:
- Transanal endoscopic microsurgery is a versatile and safe option for various rectal conditions.
- Few complications are associated with TEM, with many patients treated as outpatients.
- TEM provides a precise and effective minimally invasive surgical solution.
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