Transanal endoscopic microsurgery for rectal cancer

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Gastroenterology

Background:

• Total mesorectal excision (TME) has been the gold standard for rectal cancer surgery since the 1980s.
• TME involves removing the rectum and surrounding mesorectal fat, reducing local recurrence by excising lymph nodes.
• Despite its efficacy, TME is linked to significant morbidity, including incontinence, stoma formation, and sexual/bladder dysfunction.

Purpose of the Study:

• To outline the transanal endoscopic microsurgery (TEM) technique for rectal cancer.
• To detail the indications, imaging findings, and potential complications associated with TEM.
• To present TEM as a less morbid alternative to TME in specific rectal cancer scenarios.

Main Methods:

• Review of the transanal endoscopic microsurgery (TEM) surgical technique.
• Analysis of patient selection criteria and indications for TEM.
• Documentation of characteristic imaging appearances and known complications of TEM.

Main Results:

• TEM allows for local excision of rectal tumors, potentially avoiding radical resection.
• The technique is associated with a lower complication rate compared to TME.
• Specific indications and contraindications for TEM were identified.

Conclusions:

• Transanal endoscopic microsurgery (TEM) is a viable alternative to TME for selected rectal cancers.
• TEM offers a potentially less invasive approach with reduced morbidity.
• Understanding TEM's technique, indications, and complications is crucial for its appropriate application.