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Published on: August 15, 2025
Repeated transanal endoscopic microsurgery is feasible and safe
Wisam Khoury1, Hayim Gilshtein, Dmitri Nordkin
1Colorectal Surgery Unit, Department of General Surgery, Rambam Health Care Campus, Haifa, Israel.
Summary
Repeat transanal endoscopic microsurgery (TEM) is a safe and feasible option for selected rectal lesion excisions. This procedure showed similar outcomes to primary TEM regarding operative time, hospital stay, and complications, with no fecal incontinence reported.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Procedures
- Oncology
Background:
- Transanal endoscopic microsurgery (TEM) is established for rectal lesion excision.
- The safety and feasibility of repeat TEM procedures require further investigation.
Purpose of the Study:
- To evaluate the feasibility and safety of repeat transanal endoscopic microsurgery (TEM).
- To compare outcomes of repeated TEM with primary TEM procedures.
Main Methods:
- Retrospective review of patients undergoing repeat TEM between 2000-2010.
- Comparison of operative times, hospital stay, complications, and Wexner scores between primary and repeat TEM.
- Assessment of resection adequacy via histopathology reports.
Main Results:
- Fourteen patients underwent repeat TEM for involved margins or local recurrence.
- Repeat TEM showed similar operative times, hospital stay, and complication rates compared to primary TEM.
- Anal sphincter function, assessed by Wexner score, remained comparable, with no cases of fecal incontinence.
Conclusions:
- Repeated transanal endoscopic microsurgery (TEM) is a feasible and safe endoscopic procedure.
- This approach may be suitable for carefully selected patients requiring re-excision of rectal lesions.
