Transanal endoscopic microsurgery for upper rectal tumors.

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Transanal endoscopic microsurgery (TEM) offers advantages over traditional rectal resection.
• Efficacy of TEM for upper rectal lesions (≥10 cm from anal verge) requires assessment.

Purpose of the Study:

• To evaluate the feasibility and outcomes of TEM for upper rectal lesions.
• To assess short-term and long-term efficacy, including local recurrence and survival rates.

Main Methods:

• Retrospective analysis of 99 TEM procedures in 96 patients (2001-2010).
• Inclusion criteria: rectal lesions ≥10 cm from the anal verge.
• Data collected: demographics, tumor characteristics, operative details, outcomes, histopathology. Survival and local recurrence analyzed using Kaplan-Meier and Cox regression.

Main Results:

• Mean tumor distance: 11.3 ± 2 cm; median size: 2 cm.
• Favorable early outcomes with 10% postoperative morbidity and no mortality.
• Long-term: benign lesions LR rate 5.1%; malignant lesions LR 6.9%, OS 87%.

Conclusions:

• TEM is feasible and safe for selected upper rectal lesions.
• Low morbidity, shorter operative time, and favorable long-term outcomes support TEM use.
• TEM provides a viable treatment option for upper rectal pathologies.