Transanal endoscopic microsurgery: what indications in 2013?

Area of Science:

• Colorectal surgery
• Minimally invasive surgical techniques
• Oncology

Background:

• Rectal cancer treatment has evolved with surgical advancements, neoadjuvant chemoradiation, improved staging, and screening programs.
• Transanal endoscopic microsurgery (TEM) is now a viable alternative to abdominal surgery for benign rectal lesions and early rectal cancers.
• Controversies in 2013 include TEM's role in advanced rectal cancers, post-chemoradiation complete responders, and its use in single-port and NOTES surgery.

Purpose of the Study:

• To review the current indications for transanal endoscopic microsurgery (TEM) in rectal tumor treatment.
• To discuss the future perspectives and evolving role of TEM in managing rectal conditions.

Main Methods:

• Review of current literature and clinical practices regarding transanal endoscopic microsurgery (TEM).
• Analysis of TEM's efficacy and safety in comparison to traditional surgical approaches.
• Exploration of TEM's potential in advanced rectal cancer management and novel surgical platforms.

Main Results:

• TEM is established as an effective treatment for benign rectal lesions and early-stage rectal cancers.
• Ongoing debate exists regarding TEM's application in more advanced cases and its integration with other therapeutic modalities.
• TEM shows promise as a platform for advanced minimally invasive procedures like single-port surgery and NOTES.

Conclusions:

• Transanal endoscopic microsurgery (TEM) has a defined role in treating specific rectal conditions.
• Further research is needed to clarify TEM's expanded indications, particularly in advanced rectal cancer and its integration into future surgical techniques.
• The evolution of TEM continues to shape the tailored approach to rectal cancer management.