Transanal endoscopic microsurgery for giant circumferential rectal adenomas

Area of Science:

• Colorectal surgery
• Minimally invasive surgery
• Oncology

Background:

• Transanal endoscopic microsurgery (TEM) was initially developed for infraperitoneal rectal adenomas.
• Indications for TEM have expanded to include larger and more advanced rectal lesions.

Purpose of the Study:

• To evaluate the outcomes of TEM for treating circumferential rectal lesions.
• To assess the safety and efficacy of TEM in a real-world clinical setting.

Main Methods:

• Retrospective review of 17 patients who underwent TEM for circumferential rectal lesions between September 2010 and January 2015.
• Analysis of patient demographics, lesion characteristics, operative details, and postoperative outcomes.

Main Results:

• TEM was successfully completed in all patients, with a median operating time of 120 minutes.
• Histological analysis revealed various stages of cancer, with all patients currently disease-free.
• No patients experienced faecal incontinence or significant urinary or sexual dysfunction; four required balloon dilatation for stenosis.

Conclusions:

• Transanal endoscopic microsurgery is a feasible and safe surgical option for large circumferential rectal lesions.
• TEM offers satisfactory outcomes for selected patients with rectal lesions.
• Preoperative staging accuracy for rectal lesions may be a limitation.