[Transanal endoscopic microsurgery for rectal cancer].

Area of Science:

• Colorectal Surgery
• Minimally Invasive Oncologic Procedures
• Gastrointestinal Oncology

Background:

• Local excision of rectal cancer offers advantages over radical resection, including reduced trauma, lower risks, and preservation of anal sphincter, sexual, and urinary functions.
• Transanal endoscopic microsurgery (TEM) is an increasingly prevalent local excision technique for rectal cancers worldwide.

Purpose of the Study:

• To highlight the benefits and indications of Transanal Endoscopic Microsurgery (TEM) for rectal cancer local excision.
• To emphasize TEM's technical advantages in improving operative exposure and enabling precise tumor excision.

Main Methods:

• TEM utilizes specialized instruments for delicate surgical dissection and precise tumor excision.
• Accurate preoperative evaluation and strict adherence to procedure indications are essential for successful TEM outcomes.

Main Results:

• TEM improves operative exposure and provides adequate space for precise tumor removal, minimizing positive surgical margins.
• Effective TEM requires careful patient selection and adherence to indications, including rectal adenomas (Tis), low-risk T1 rectal cancers, and specific submucosal infiltrations (Sm1-Sm2).

Conclusions:

• TEM enables locally radical excision, crucial for preventing postoperative recurrence of rectal cancer.
• Selected patients with downstaged T2-T3 rectal cancers post-neoadjuvant therapy may also be candidates for TEM in clinical studies.