Recurrence after transanal endoscopic microsurgery for large rectal adenomas.

Area of Science:

• Colorectal surgery
• Minimally invasive surgery
• Oncology

Background:

• Transanal endoscopic microsurgery (TEM) is a standard for large sessile rectal adenomas.
• Few studies identify recurrence risk factors for tailored TEM approaches.
• This study aimed to find predictors of recurrence after TEM for rectal adenoma.

Purpose of the Study:

• Identify predictor variables for local recurrence after TEM.
• Evaluate risk factors associated with TEM for rectal adenoma treatment.
• Contribute to a tailored approach in transanal surgery.

Main Methods:

• Retrospective analysis of a prospective database (1993-2010).
• Patients with rectal adenoma ≥3 cm treated with TEM.
• Investigated age, gender, tumor diameter, margin status, and more.

Main Results:

• 293 patients underwent TEM; 5.6% experienced local recurrence.
• Tumor diameter and positive margins were significant univariate risk factors.
• Positive margins were the only independent predictor of recurrence (multivariate analysis).

Conclusions:

• TEM offers excellent oncological outcomes for large sessile rectal lesions.
• Pathological examination of resection margins is crucial.
• Positive margins are the sole identified risk factor for recurrence post-TEM.